Brain scans could predict psychosis before it happens

Key points:

• About one in every 200 adult Australians will experience a psychotic illness each year

• A first episode of psychosis is most likely to happen in a person’s late teens or early adult years

• Research has shown the best outcomes occur when psychosis is detected and treated early, before the illness has a chance to worsen

Researchers have been able to classify brain scans of healthy people and identify people’s risk of experiencing psychosis before the onset of an episode.

The team of scientists from 21 different institutions in 15 different countries gathered a large and diverse group of adolescent and young adult participants — as people are most likely to experience psychosis during this age range.

There is no single cause, but it can be triggered by illness or injury, trauma, drug or alcohol use, medication or a genetic predisposition and can lead to symptoms such as:

• hallucinations;
• delusions;
• disorganised thinking.

Previous studies using brain MRI have suggested that structural differences occur in the brain after the onset of psychosis. However, this is reportedly the first time that differences in the brains of those who are at very high risk but have not yet experienced psychosis have been identified.

Associate Professor Shinsuke Koike from the Graduate School of Arts and Sciences at the University of Tokyo explained that it can be difficult to identify young people in need of help.

“At most, only 30 percent of clinical high-risk individuals later have overt psychotic symptoms, while the remaining 70 percent do not,” he said.

“Therefore, clinicians need help to identify those who will go on to have psychotic symptoms using not only subclinical signs, such as changes in thinking, behaviour and emotions but also some biological markers.

According to Koike, MRI research into psychotic disorders can be challenging because variations in brain development and in MRI machines make it difficult to get very accurate, comparable results.

“Different MRI models have different parameters which also influence the results,” he added.

“Just like with cameras, varied instruments and shooting specifications create different images of the same scene, in this case, the participant’s brain. However, we were able to correct for these differences and create a classifier which is well tuned to predicting psychosis onset.”

In training, the tool was 85 percent accurate at classifying the results, while in the final test using new data, it was 73 accurate at predicting which participants were at high risk of psychosis onset.

“We still have to test whether the classifier will work well for new sets of data. Since some of the software we used is best for a fixed data set, we need to build a classifier that can robustly classify MRIs from new sites and machines, a challenge which a national brain science project in Japan, called Brain/MINDS Beyond, is now taking on,” said Koike.

“If we can do this successfully, we can create more robust classifiers for new data sets, which can then be applied to real-life and routine clinical settings.”

Psychotic disorders may be covered under the National Disability Insurance Scheme for psychosocial supports. For more information about applying for NDIS support, please refer to the NDIS Mental Health portal to learn more.

Would Australia benefit from early detection and identifying people at risk of psychosis? Let the team at Talking Disability know your thoughts and subscribe to the newsletter for more information, news and industry updates.

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