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Mapping prodromal psychosis: A critical review of neuroimaging studies

Published online by Cambridge University Press:  15 April 2020

P. Fusar-Poli ,
P. McGuire  and
S. Borgwardt
P. Fusar-Poli*
Affiliation:
Institute of Psychiatry, Department of Psychosis Studies, London, United Kingdom
P. McGuire
Affiliation:
Institute of Psychiatry, Department of Psychosis Studies, London, United Kingdom
S. Borgwardt
Affiliation:
Institute of Psychiatry, Department of Psychosis Studies, London, United Kingdom
*
*Corresponding author. De Crespigny Park 16, Institute of Psychiatry, Department of Psychosis Studies, SE58AF London, United Kingdom. Tel.: +44 7786 666 570; fax: +44 2078 480 976. [email protected] (P. Fusar-Poli).
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Abstract

The onset of schizophrenia is usually preceded by a prodromal phase characterized by functional decline and subtle prodromal symptoms, which include attenuated psychotic phenomena, cognitive deterioration and a decline in socio-occupational function. Preventive interventions during this phase are of great interest because of the impressive clinical benefits. However, available psychopathological criteria employed to define a high risk state for psychosis have low validity and specificity. Consequently there is an urgent need of reliable neurocognitive markers linked to the pathophysiological mechanisms that underlie schizophrenia. Neuroimaging techniques have rapidly developed into a powerful tool in psychiatry as they provide an unprecedented opportunity for the investigation of brain structure and function. This review shows that neuroimaging studies of the prodromal phases of psychosis have the potentials to identify core structural and functional markers of an impending risk to psychosis and to clarify the dynamic changes underlying transition to psychosis and to address significant correlations between brain structure or function and prodromal psychopathology. Additionally, neurochemical methods can address the key role played by neurotransmitters such as dopamine and glutamate during the psychosis onset. To conclude, multimodal neuroimaging may ultimately clarify the neurobiology of the prodromal phases by the integration of functional, structural and neurochemical findings.

Keywords

NeuroimagingPsychosisSchizophreniaProdromalFMRIPETHR, High RiskARMS, At Risk Mental StateCOPS, Criteria for Prodromal SyndromesFMRI, Functional Magnetic Resonance ImagingSMRI, Structural Magnetic Resonance ImagingPET, Positron Emission TomographyMRS, Magnetic Resonance SpectroscopyNMDAR, N-methyl-D-aspartate receptorVBM, Voxel-based MorphometryHR-T-, High Risk subjects with a subsequent transition to psychosisHR-NT-, High Risk subjects without a subsequent transition to psychosis
Type
Reviews
Information
European Psychiatry , Volume 27 , Issue 3 , April 2012 , pp. 181 - 191
Copyright
Copyright © Elsevier Masson SAS 2012

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