Brain folds key to diagnosing psychosis early, Western study finds

From the London Free Press

The brain’s outer folds and ridges can be a road map for researchers trying to diagnose which patients are at the highest risk of psychosis later in life, a new Western University study says.

By analyzing brain scans of at-risk patients, researchers have been able to predict which ones will develop psychosis with more than 80 per cent accuracy.

The new development will make it easier for researchers to examine young people before they get sick and identify which ones are most likely to develop psychosis.

“Currently there is no tool available for clinicians to pinpoint which of those who are at risk, will go on to develop psychosis,” postdoctoral fellow Tushar Das said in a statement.

“Our end goal is to apply this to the clinic. Our idea would be to identify these patients before they fall into a psychotic illness.”

Western and Lawson Health Research Institute researchers teamed up with scientists from the University of Basel in Switzerland for the study. Using magnetic resonance imaging (MRI) technology, the group developed a strategy to analyze the brain’s structure and figure out which patients with early psychotic symptoms could go on to develop full-blown illness later in life.

Researchers collected brain images from 161 participants in Switzerland for the study, which is published today in JAMA Psychiatry. Of the 161, 44 were healthy control subjects, 38 were patients who had experienced brief hallucinations or delusions and 79 had an increased risk of psychosis.

Since about one in seven young people experience psychosis-risk symptoms but only one per cent will develop psychotic disorders like schizophrenia, study authors followed the participants for four years.

The researchers looked at the structure of the brain and the way it’s folded inside the skull, also known as gyrification.

“Elephants and dolphins have larger brains than we do, but our brain is much more folded than other species’ brains, and that is because it is the most economical way to send signals across a constantly busy system,” said Western’s Schulich School of Medicine and Dentistry associate professor Dr. Lena Palaniyappan in a statement.

Since the brain’s folded fingerprint is mostly developed by the time a person is two years old, researchers say the findings may suggest psychotic illness is largely developmental instead of something degenerative that comes with age.

The research could help doctors identify and treat potential psychosis patients early, long before their first episode — a strategy that could lead to better outcomes.

“We not only know that early intervention works, but many interventions for psychosis work only if they are given early enough,” Palaniyappan said.

“If we can identify patients early, before they drop out of schools or lose their jobs due to a psychotic episode, we can reverse the trajectory of this illness.”