Structural and Functional Neuroimaging Biomarkers as Predictors of Psychosis Conversion in Ultra-High Risk...

Area of Science:

• Neuroimaging
• Psychiatry
• Neuroscience

Background:

• 20-30% of ultra-high risk (UHR) individuals transition to psychosis within 2-3 years.
• Identifying neurobiological markers for psychosis conversion is crucial for precision prevention.

Purpose of the Study:

• To systematically identify and evaluate baseline neuroimaging biomarkers in UHR individuals that predict subsequent psychosis conversion.
• Focus on structural and functional neuroimaging markers.

Main Methods:

• Systematic review following PRISMA 2020 guidelines, searching five databases (Jan 2000-Feb 2025).
• Included 25 studies with 2436 UHR individuals (627 converters).
• Assessed structural MRI, fMRI, DTI, and MRS for prediction of psychosis conversion.

Main Results:

• Reduced gray matter volume in medial temporal and prefrontal regions predicted conversion.
• Progressive gray matter loss in the superior temporal gyrus and reduced prefrontal-temporal connectivity were observed in converters.
• White matter integrity (uncinate fasciculus, superior longitudinal fasciculus), elevated striatal glutamate, and thalamocortical dysconnectivity also predicted transition.
• Multimodal imaging models achieved 78-85% classification accuracy.

Conclusions:

• Neuroimaging biomarkers, including structural alterations, functional dysconnectivity, and white matter abnormalities, effectively predict UHR conversion.
• Multimodal approaches combining structural, functional, and neurochemical measures show significant promise for individualized risk prediction and early intervention in psychosis prevention.