Researchers from several American and Canadian universities announced in a new study that they have discovered a link between cognition and brain networks before a psychotic breakdown, which occurs when a person loses contact with reality in individuals at risk of developing psychotic disorders such as schizophrenia. The study is believed to contribute to finding an opportunity for early diagnosis and intervention to treat these symptoms that resist treatment.
What is psychosis?
Psychosis is a condition in which a person loses some contact with reality. This may include seeing or hearing things that other people cannot see or hear (hallucinations), believing things that are not real (delusions), and may also include distorted thinking and speech.
Sometimes psychosis can be identified as a specific mental health condition, such as schizophrenia, which causes a range of psychological symptoms, including hallucinations and delusions, and bipolar disorder, which is a mental health condition that affects mood. A person with bipolar disorder can experience episodes of low mood (depression) to highs or euphoric moods (mania). Psychosis can also be linked to major depression, as some people with depression also experience symptoms of psychosis when they are very depressed, according to the NHS.
Brain networks and mind
Cognitive disturbances in psychotic disorders—such as schizophrenia and bipolar disorder—are linked to the organization of brain networks, according to new research. This link between cognition and brain networks exists in individuals at risk for psychotic disorders even before their first psychotic breakdown. This groundbreaking study, published in the journal Biological Psychiatry, suggests an opportunity for early diagnosis and intervention to treat these treatment-resistant symptoms.
“Cognitive impairment is very common in schizophrenia and other psychotic disorders,” explains lead author Heather Brill Ward, MD, of the Department of Psychiatry and Behavioral Sciences at Vanderbilt University Medical Center. “There are currently no medications to treat cognitive impairment, which can lead to significant disability. This impairment is often present by the time a person experiences their first psychotic episode, making early detection and intervention crucial. Our current study is part of our efforts to understand and address treatment-resistant symptoms in psychotic disorders.”
Tests
The study used an advanced MRI analysis approach to identify connections between brain regions and a cognitive test designed for people with psychosis.
The study also used the Seidman Continuous Auditory Performance Test (ACPT), a neuropsychological test used to measure sustained attention and vigilance, particularly in the auditory domain. It is an auditory version of the CPT, in which a person listens to a series of sounds or words and must respond to specific auditory stimuli while ignoring other stimuli. The test assesses the participant’s ability to maintain focus and discriminate between target and non-target sounds over a set period of time.
Research suggests that increased connectivity between the frontal cortex and sensorimotor areas is associated with improved attention (as measured by an auditory performance test) in individuals with early psychosis, or who are at high risk for developing psychosis. However, this association was not observed in healthy individuals or those who were at risk and did not develop psychosis. This may suggest that changes in brain connectivity in these areas are particularly important in the early stages of psychotic disorders.
“In this new study, researchers used a combination of multivariate, data-driven analysis to identify neural networks and correlate them with disease-specific cognitive assessments to identify a novel, replicable relationship between brain connectivity and cognitive performance in psychotic disorders, providing important insights for early detection and intervention in psychotic disorders,” said Dr. John Crystal, editor of the journal Biological Psychiatry, in a commentary on the study’s findings, according to EurekAlert.