Dr. Tyrone Cannon, Professor of Psychology and Psychiatry at Yale University, and his collaborators in the North American Prodrome Longitudinal Study Consortium have now provided important new insights into cortical changes associated with the development of psychosis. They conducted a longitudinal MRI study across 8 U.S. sites.

They recruited 274 individuals at clinical high risk for psychosis and 135 healthy controls. Each participant received an initial (baseline) scan and a second scan either one year later or at the time of conversion to psychosis. Thirty-five individuals ultimately converted to psychosis and they showed a steeper rate of thinning in prefrontal cortex compared with those who did not convert and the healthy control group. Importantly, this tissue loss was not explained by exposure to antipsychotic drugs.

Interestingly, the tissue loss observed in the converters was correlated with levels of proinflammatory cytokines in plasma, suggesting the presence of systemic neuroinflammation.

Dr. Cannon quoted "The findings are also important in showing that markers of proinflammatory cytokines at the baseline assessment predicted the rate of gray matter loss among the individuals who converted to psychosis, suggesting that activation of microglia was involved in the tissue loss. This could mean that psychosis is associated with an abnormal acceleration in the processes underlying normal synaptic pruning during late adolescence/early adulthood, or that some kind of immune-related process is involved in psychosis onset, or both."

It recommends that future work be conducted to evaluate whether inflammation precedes and perhaps even predicts such gray matter loss, or whether it is a consequence of such loss.

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