Research led by Stanford University School of Medicine finds two key brain systems at the heart of psychosis

Researchers compared brain scans of people with 22q11.2 deletion syndrome with and without psychosis and found that the brain regions most affected by psychosis were the anterior insula (a key part of the salience network or filter) and the ventral insula. Striatum (reward predictor); this is true for different patient groups.

When comparing the brain signatures of people with 22q11.2 deletion syndrome and psychosis to those of people with unexplained psychosis, the model found significant overlap, suggesting that these brain features are often characteristic of psychosis.

A second mathematical model trained to distinguish all subjects with 22q11.2 deletion syndrome and psychosis from subjects with the genetic syndrome but no psychosis selected idiopathic psychosis patients The brain scan was 77.5% accurate, once again supporting the idea of ​​brain filtering.

Furthermore, the model is psychotic: it cannot classify people with idiopathic autism or ADHD.

Menon said it was very exciting to go back to our original question, “What are the dysfunctional brain systems in schizophrenia?” and find similar patterns in this condition. Characteristics of individuals with syndromic psychosis mirror the pathways we have identified in schizophrenia. This similarity enhances our understanding of psychosis as a disorder with identifiable and consistent brain characteristics. provides clues about future research directions, he added.

Therapeutic or preventive applications

In addition to supporting scientists’ theories about how psychosis occurs, the findings have important implications for understanding the condition and possibly preventing it.

“One of my goals is to prevent or delay the development of schizophrenia,” Supeka said. He said the fact that the new findings are consistent with the team’s previous research on which brain centers are most affected by schizophrenia in adults suggests there may be a way to prevent the condition. In schizophrenia, by the time of diagnosis, much damage has already occurred to the brain, and it is difficult to change the course of the disease.

What we see, he adds, is that early on, functional interactions between brain regions within the same brain system are abnormal. These abnormalities don’t start appearing in your 20s; they can be noticeable even when you are 7 or 8 years old.

Our findings highlight the importance of treating patients with psychosis with compassion.

The researchers plan to use existing treatments, such as transcranial magnetic stimulation or focused ultrasound, to target young people at risk for psychosis (such as those with 22q11.2 deletion syndrome or those whose parents have schizophrenia). of these brain centers to see if they can prevent or delay the onset of the condition, or reduce symptoms after they occur.

The findings also suggest that using functional MRI to monitor brain activity in key centers could help scientists study the effects of existing antipsychotic drugs.

Why someone would lose touch with reality is still puzzling, but now understandable, despite how risky it may seem to a person’s well-being, Supeka said. From a mechanistic perspective, it makes sense, he said.

Menon said our findings underscore the importance of treating people with mental illness with compassion. change.

He said, I recently had the opportunity to interact with individuals from our department’s Early Psychiatry Team. Just like anyone, we experience our own highs and lows. This is a call to view mental illness through the lens of empathy and solidarity.

Researchers from the University of California, Los Angeles, Clinica Alemana Universidad del Desarrollo, Pontificia Universidad Catlica de Chile, the University of Oxford, and the University of California, Davis, contributed to the study.

The study was funded by the Uytengsu-Hamilton 22q11 Neuropsychiatry Research Program at the Stanford Institute for Maternal and Child Health, FONDEYCT (National Fund for the Development of Science and Technology of the Government of Chile), ANID-Chile (Chile’s National Agency for Research and Development), and the U.S. National Institutes of Health (Grants AG072114, MH121069, MH085953, and MH101779).