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By On November 19th, 2018

Distinct brain patterns could help diagnose schizophrenia earlier

Image source: MIT News

Schizophrenia is perhaps one of the most talked about mental illnesses, but it is also the most poorly understood. Rather than the multiple personalities many associate with schizophrenia, the brain disease is actually characterized by hallucinations, delusions, paranoia, and cognitive impairments.

While research has helped uncover some factors that can help predict those at risk for the disorder, it is incredibly difficult to accurately diagnose the condition until a significant psychotic episode happens. This is troubling, as a psychotic episode can often be traumatic and have lasting ramifications on a person’s life.

Now, researchers from several universities and medical centers including MIT, Shanghai Mental Health Center, and Brigham and Women’s Hospital, believe they have found an observable pattern of brain activity that could be used to accurately used as an early marker for the disease. If proven, it could open the possibility for interventions and treatments before a psychotic episode occurs.

“You can consider this pattern to be a risk factor. If we use these types of brain measurements, then maybe we can predict a little bit better who will end up developing psychosis, and that may also help tailor interventions,” says Guusje Collin, a visiting scientist at MIT’s McGovern Institute for Brain Research and the lead author of the study published in the journal Molecular Psychiatry.

In the past, the only signs of schizophrenia that could be identified before a psychotic episode were subtle symptoms like jumping from topic to topic seemingly at random or giving non-sequitur answers to questions. However, studies suggest that only approximately 25% of people with these symptoms later develop schizophrenia. Additionally, these symptoms can be easily misdiagnosed as another form of mental illness or cognitive impairment.

In their search for a more definitive biomarker, the team of researchers followed 159 people between the ages of 13 and 34 who were experiencing these early symptoms and 93 people who were at low to no risk for schizophrenia.

At the start of the study, the participants underwent functional magnetic resonance imaging (fMRI) to assess their “resting state networks”. These networks consist of brain regions that tend to connect and communicate most when the brain is not busy performing specific cognitive tasks.

“We were interested in looking at the intrinsic functional architecture of the brain to see if we could detect early aberrant brain connectivity or networks in individuals who are in the clinically high-risk phase of the disorder,” Whitfield-Gabrieli explained to MIT News.

After a year, the researchers followed up with the participants and found that 23 of the high-risk group had been diagnosed with schizophrenia after a psychotic episode. In the scans a year earlier, these 23 showed a distinct pattern of brain activity that was not present in either the control participants or those who experienced the early symptoms without developing psychosis.

Particularly, the researchers found that those who developed psychosis showed increased connectivity in the superior temporal gyrus, which is associated with auditory processing. According to the researchers, this could explain why those with schizophrenia experience auditory hallucinations.

The findings are the first of their kind and will have to be replicated in future research. Still, the team believes the findings open the door for potential interventions that could prevent psychotic episodes or at least allow for better management and minimalization of these breaks with reality.

“That really gets at the heart of how we can translate this clinically, because we can get in earlier and earlier to identify aberrant networks in the hopes that we can do earlier interventions, and possibly even prevent psychiatric disorders,” Whitfield-Gabrieli says.

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