Transition to Psychosis Associated With Prefrontal and Subcortical Dysfunction in Ultra High-Risk Individuals

P. Allen, J. Luigjes, Oliver Howes, A. Egerton, K. Hirao, I. Valli, J. Kambeitz, Paolo Fusar-Poli, M. Broome, P. McGuire

Research output: Contribution to journalArticlepeer-review

111 Citations (Scopus)

Abstract

Background: People at ultra high risk (UHR) of psychosis have an elevated risk of developing a psychotic disorder, but it is difficult to predict which individuals will make a transition to frank illness. We investigated whether functional magnetic resonance imaging (fMRI) in conjunction with a phonological fluency task at presentation could distinguish subjects who subsequently developed psychosis from those who did not.

Methods: Sixty-five subjects (41 with an UHR and 24 healthy controls) were assessed at clinical presentation using fMRI, in conjunction with a verbal fluency task. [18F]-DOPA positron emission tomography (PET) data were also available in a subgroup of 21 UHR and 14 healthy controls subjects. UHR subjects were followed clinically for at least 2 years.

Results: Compared with UHR subjects who did not become psychotic, UHR subjects who subsequently developed psychosis showed increased activation in bilateral prefrontal cortex (PFC), brainstem (midbrain/basilar pons), the left hippocampus, and greater midbrain-PFC connectivity. Furthermore, exploratory analysis of [18F]-DOPA PET data showed that transition to psychosis was associated with elevated dopaminergic function in the brainstem region.

Conclusions: In people at high risk of psychosis, increased activation in a network of cortical and subcortical regions may predict the subsequent onset of illness. Functional neuroimaging, in conjunction with clinical assessment and other investigations, may facilitate the prediction of outcome in subjects who are vulnerable to psychosis.
Original languageEnglish
Article numberN/A
Pages (from-to)1268-1276
Number of pages9
JournalSchizophrenia Bulletin
Volume38
Issue number6
DOIs
Publication statusPublished - Nov 2012

Keywords

  • Adult
  • Brain
  • Brain Mapping
  • Case-Control Studies
  • Dihydroxyphenylalanine
  • Disease Progression
  • Female
  • Fluorine Radioisotopes
  • Functional Neuroimaging
  • Hippocampus
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Mesencephalon
  • Pons
  • Positron-Emission Tomography
  • Prefrontal Cortex
  • Prodromal Symptoms
  • Psychotic Disorders
  • Radiopharmaceuticals
  • Risk
  • Speech Production Measurement

Fingerprint

Dive into the research topics of 'Transition to Psychosis Associated With Prefrontal and Subcortical Dysfunction in Ultra High-Risk Individuals'. Together they form a unique fingerprint.

Cite this