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Computational neuroscience models show that volatility priors and caudate nucleus activation can be altered in patients with persecutory delusions. These findings suggest volatility priors may be a novel therapeutic target for psychosis interventions.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Computational Psychiatry

Background:

  • Persecutory delusions are a common, distressing, and challenging symptom in psychiatric disorders.
  • Computational neuroscience offers potential new therapeutic targets for delusions by modeling underlying cognitive mechanisms.

Purpose of the Study:

  • To investigate the association between changes in delusion severity and corresponding alterations in volatility priors and brain activation.
  • To explore the potential of targeting volatility priors as an intervention for psychosis.

Main Methods:

  • A randomized clinical trial compared cognitive behavioral therapy for psychosis (CBTp) with befriending therapy in adults with schizophrenia spectrum or delusional disorder.
  • Volatility priors, delusion severity (using PSYRATS), and brain activation (fMRI) were measured before and after the 8-week intervention.
  • Associations between changes in volatility priors, clinical outcomes, and neural activation were analyzed.

Main Results:

  • Both CBTp and befriending therapy led to decreased volatility priors and delusion severity across both groups.
  • A decrease in volatility priors was not directly associated with clinical improvement in delusion severity.
  • Reduced activation in the caudate nucleus was linked to decreased volatility priors, independent of antipsychotic medication.

Conclusions:

  • Elevated volatility priors and associated caudate nucleus activation are modifiable in individuals with persecutory delusions.
  • Volatility priors represent a potential novel therapeutic target for interventions in psychosis.
  • Further research is warranted to explore the clinical utility of targeting volatility priors in psychosis treatment.