Research in Brief: Mapping the Mind

New Study Lights Path for Early Detection of Schizophrenia and Other Psychotic Disorders

Groundbreaking research led by psychiatrists at Beth Israel Deaconess Medical Center (BIDMC) revealed that the brain may hold crucial clues for detecting psychotic disorders—a class of mental illnesses marked by a loss of contact with reality—before they fully manifest. In a study of individuals with psychotic disorders such as schizophrenia, scientists uncovered a connection between cognitive impairment and brain network organization that could offer an opportunity for early detection and intervention prior to psychotic break.

“This study is part of our ongoing work to understand and treat the medication resistant symptoms of diseases like schizophrenia,” said lead author Roscoe O. Brady, Jr., Vice-Chair for Research, Department of Psychiatry, BIDMC. “We used imaging to identify a brain signature of schizophrenia’s cognitive deficits in individuals who would eventually develop psychosis in the future. This is something that I believe has never been shown before. It’s a first real step to using brain imaging to help identify targets for prevention of these cognitive deficits.”

Highly prevalent in people with psychotic disorders, cognitive impairment is a common symptom of psychosis that can result in significant disability. No medications are currently available to treat cognitive impairment, which can include difficulties with memory, attention, learning and interpreting social cues. Notably, these impairments are frequently present prior to an individual’s first psychotic break—an episode during which individuals have difficulty distinguishing what’s real from what is not, often marked by delusions or hallucinations.

Using MRI analysis and cognitive testing pioneered by the late Lawrence J. Siedman, a prominent neuropsychologist at BIDMC, the physician-scientists demonstrated that cognitive impairment is linked to a characteristic pattern of brain network organization in individuals with known psychotic disorders. When they focused on at-risk individuals who hadn’t experienced a psychotic break yet, the scientists showed that participants’ odds of experiencing a psychotic break within the next two years was also significantly linked to the same pattern of brain network organization.

The findings suggest that this brain-cognition link is present before the first psychotic episode, opening up a promising window for early intervention for potentially altering the course of psychotic disorders, which have long been resistant to traditional treatments.

Read the full paper in Biological Psychiatry.

BIDMC Study Authors: Adam Beermann, Jing Xie, Gulcan Yildiz, Karlos Manzanarez Felix, Matcheri Keshevan, Larry Seidman, William S. Stone, Roscoe O Brady, Junior.

COI: The authors have no competing interests to disclose.

Citation: Ward H.B., Beermann A., Xie J., Yildiz G., Felix K.M., Addington J., Bearden C.E., Cadenhead K., Cannon T.D., Cornblatt B., Keshavan M., Mathalon D., Perkins D.O., Seidman L., Stone W.S., Tsuang

M.T., Walker E.F., Woods S., Coleman M.J., Bouix S., Holt D.J., Öngür D., Breier A., Shenton M.E., Heckers S., Halko M.A., Lewandowski K.E. & Brady R.O., Jr, Robust Brain Correlates of Cognitive Performance in Psychosis and its Prodrome, Biological Psychiatry (2024).