New research has uncovered a significant link between cognitive impairments and brain network organization in individuals with psychotic disorders like schizophrenia and bipolar disorder.
This discovery could pave the way for early diagnosis and intervention, potentially addressing cognitive symptoms before they become debilitating.
The study, published in Biological Psychiatry, reveals that even before an individual experiences their first psychotic break, changes in brain networks related to cognition are already detectable.
Cognitive impairment is a common and challenging symptom in psychotic disorders. Dr. Heather Burrell Ward, the lead author from Vanderbilt University Medical Center, highlights the urgency of this issue:
“Cognitive impairment is highly prevalent in schizophrenia and other psychotic disorders. Unfortunately, we currently have no effective medications to treat these cognitive symptoms, which can lead to significant disability for those affected.”
Dr. Ward’s study focuses on understanding these hard-to-treat symptoms with the hope of finding better ways to detect and manage them early on.
Many people with psychotic disorders exhibit cognitive difficulties, such as problems with memory, attention, and overall thinking abilities, even before their first psychotic episode. Identifying these issues early could be key to preventing the progression of the disorder.
Traditional approaches to studying cognitive impairment in psychotic disorders often rely on cognitive tests designed for the general population. However, these tests may not fully capture the unique ways in which cognition is affected in people with psychosis.
To address this gap, the researchers used advanced MRI analysis techniques and a cognitive test specifically designed for individuals with psychosis. This allowed them to explore how cognitive performance is related to the organization of brain networks in a more targeted way.
The study drew on data from two major research projects: the Human Connectome Project for Early Psychosis (HCP-EP) and the North American Prodrome Longitudinal Study (NAPLS).
These projects provided a rich dataset that enabled the researchers to analyze brain connectivity patterns in people with psychotic disorders.
Dr. Roscoe O. Brady, Jr., a co-senior author from Harvard Medical School, explains the key finding: “We observed that in individuals with psychotic disorders, cognitive impairment is linked to brain network organization.
We then took an innovative step by asking whether we could detect this same brain signature of cognitive impairment in individuals who were at risk for psychotic disorders but had not yet experienced a psychotic break.”
Remarkably, the researchers found that this brain network-cognition relationship was present in individuals who were at risk of developing psychosis in the future.
This suggests that the changes in brain networks associated with cognitive impairment may be detectable well before the onset of full-blown psychosis.
Dr. John Krystal, Editor of Biological Psychiatry, notes the significance of these findings: “This study offers important insights into the early detection and intervention of psychotic disorders.
The researchers used a combination of advanced brain imaging analysis and a cognitive assessment tailored to psychosis, leading to the identification of a new, reproducible link between brain connectivity and cognitive performance in these disorders.”
The implications of this research are far-reaching. Dr. Kathryn E. Lewandowski, another co-senior author from Harvard Medical School, points out that this discovery is part of a larger, ongoing international effort to identify biomarkers and targets for intervention in individuals at risk for psychotic disorders.
This effort, known as the Accelerating Medicines Partnership Schizophrenia (AMP SCZ), aims to improve early diagnosis and treatment options.
Dr. Lewandowski emphasizes that the observed link between cognition and brain networks, detectable even before a psychotic break, presents a valuable opportunity for early intervention.
Noninvasive techniques, such as neuromodulation, could be explored as potential treatments to target these early brain changes, potentially altering the course of the disorder before it fully develops.
In summary, this study provides new hope for those at risk of psychotic disorders.
By identifying early changes in brain networks linked to cognitive impairment, researchers are opening up new possibilities for early diagnosis and intervention, which could ultimately improve outcomes for individuals at risk of these challenging conditions.
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The research findings can be found in Biological Psychiatry.
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