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Striatal functional connectivity in psychosis relapse: A hypothesis generating study.

Jose M Rubio1, Todd Lencz1, Anita Barber2

  • 1The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA.

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Summary
This summary is machine-generated.

Relapse in psychotic disorders may involve altered striatal connectivity. Individuals experiencing breakthrough psychosis despite antipsychotic treatment showed lower striatal connectivity index (SCI) than those who discontinued medication.

Keywords:
InjectableRelapseResting state functional connectivity

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Medical Imaging

Background:

  • Psychotic disorders frequently involve relapse, with underlying neural mechanisms poorly understood.
  • Antipsychotic adherence status upon relapse may indicate distinct underlying neural processes.
  • Striatal connectivity index (SCI) is a potential biomarker for treatment response in psychosis.

Purpose of the Study:

  • To compare the striatal connectivity index (SCI) based on antipsychotic adherence status at relapse.
  • To investigate neural differences between breakthrough psychosis, medication discontinuation relapse, and healthy controls.

Main Methods:

  • Resting-state functional magnetic resonance imaging (fMRI) was used to generate functional connectivity maps.
  • Striatal connectivity index (SCI) was calculated using region of interest (ROI) analyses.
  • Linear regression compared SCI values across groups: breakthrough psychosis (n=23), non-adherent relapse (n=27), and healthy controls (n=26).

Main Results:

  • Breakthrough psychosis group exhibited significantly lower SCI than healthy controls (Cohen's d=0.99, p<0.001).
  • Breakthrough psychosis group also showed significantly lower SCI than non-adherent individuals (Cohen's d=0.58, p=0.032).
  • Non-adherent individuals trended towards lower SCI compared to healthy controls (Cohen's d=0.44, p=0.09).

Conclusions:

  • Striatal functional connectivity may be aberrant in psychosis relapse.
  • This dysfunction appears more pronounced in individuals relapsing despite ongoing antipsychotic treatment.