Distinct brain region alterations in youth with psychosis spectrum disorders

Youth with psychosis spectrum disorders have distinct brain alterations in regions that are important for real-world functioning and cognitive abilities

Washington, DC, October 29, 2019

Psychotic spectrum (PS) disorders are characterized by abnormalities in beliefs, perceptions and behavior, but how these disorders manifest themselves in earlier development stages is largely unknown. A new study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports differences in brain structure among youth with PS disorders relative to typically developing youth.

The study found surface area reductions in a number of cortical brain regions in comparison to typically developing youth; youth with bipolar spectrum disorders; and youth with both psychosis and bipolar spectrum disorders. The brain regions involved are important for everyday functioning and cognitive abilities.

“Psychosis is viewed as a psychiatric disorder that arises from neurodevelopmental alterations.  However, until recently, the focus of neuroimaging studies has been on adults who have already developed a psychotic disorder,” said lead author Maria Jalbrzikowski, PhD, Assistant Professor in the Department of Psychiatry at the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. “With access to large, publicly available datasets such as the Philadelphia Neurodevelopmental Cohort, we can really start to investigate how alterations in neurodevelopment contribute to the development of psychotic symptoms.”

The findings are based on the structural neuroimaging analyses conducted on participants from the Philadelphia Neurodevelopmental Cohort (PNC), a population-based sample of 10,000 youth in the Philadelphia metro area, between the ages of 9 and 22 years old.

Structural magnetic resonance neuroimaging (MRI) data were collected on a subset of the cohort (N = 989), followed by measuring the cortical thickness, surface areas of the brain. Subcortical volumes were then calculated; study participants were assessed for psychiatric symptomatology using a structured interview and the following groups were created: typically developing (n = 376); psychosis spectrum (n = 113); bipolar spectrum (n = 117); and PS + bipolar spectrum (n = 109).

Compared with all other groups, PS youth exhibited significantly decreased surface area in the orbitofrontal, cingulate, precentral, and postcentral regions. PS youth also exhibited deceased thalamic volume compared with all other groups.  The brain alterations were restricted to youth with only PS symptoms, not youth who exhibited both psychosis spectrum and bipolar spectrum symptoms.

“This suggests that those who have both types of symptoms (psychosis and bipolar spectrum) may have different underlying neural mechanisms that contribute to symptoms, in comparison to those with psychotic spectrum symptoms only,” said Dr. Jalbrzikowski.


Notes for editors
The article is "Structural Brain Alterations in Youth With Psychosis and Bipolar Spectrum Symptoms,” by Maria Jalbrzikowski, PhD, David Freedman, PhD, Catherine E. Hegarty, PhD, Eva Mennigen, PhD, Katherine H. Karlsgodt, PhD, Loes M. Olde Loohuis, PhD, Roel A. Ophoff, PhD, Raquel E. Gur, MD, PhD, and Carrie E. Bearden, PhD (https://doi.org/10.1016/j.jaac.2018.11.012). It currently appears on the JAACAP Articles In Press page and will appear in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 58, issue 11 (November 2019), published by Elsevier.

Dr. Jalbrzikowski is an Assistant Professor in the Department of Psychiatry at the University of Pittsburgh.  She received her PhD in Clinical Psychology from UCLA in 2013, and currently has support from a K01 career development award from the National Institute of Mental Health (NIMH). Dr. Jalbrzikowski has completed multiple postdoctoral experiences in neurobehavioral genetics, developmental cognitive neuroscience, and neuroimaging genetics.

Copies of this paper are available to credentialed journalists upon request; please contact Mary Billingsley at mbillingsley@aacap.org or +1 202 587 9672. Journalists wishing to interview the authors may contact Maria Jalbrzikowski, PhD at jalbrzikowskime@upmc.edu.

Journal of the American Academy of Child and Adolescent Psychiatry(JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The Journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families. www.jaacap.org

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Media contact
Mary Billingsley
JAACAP Editorial Office
+1 202 587 9672