Introduction to Psychosis and Its Stages
Psychosis is a complex mental health condition characterized by a disconnection from reality, often manifesting through hallucinations and delusions. Patients in the early stages of psychosis exhibit different responses to treatment compared to those with chronic psychosis. Understanding the neurobiological changes that occur as psychosis progresses from early to chronic stages is crucial for developing effective prevention and treatment strategies. However, the specific changes in symptoms and the role of brain networks during this transition remain unclear.
Research at Yale School of Medicine
Researchers at Yale School of Medicine have conducted a study to explore the evolution of symptoms in patients with early and chronic forms of psychosis. The study aimed to identify relevant brain networks associated with these symptoms. The findings were published in the journal Neuropsychopharmacology.
Maya Foster, the first author of the study and a Ph.D. student in the lab of Dustin Scheinost, Ph.D., associate professor of radiology and biomedical imaging at Yale, stated, “We are interested in how psychosis and psychiatric disorders develop. With this study, we looked at the underlying brain networks—regions that are functionally connected and work in coordination—to link brain areas to symptoms in patients with either early or chronic psychosis, and we assessed the similarities and differences between these networks.”
Understanding Psychosis Symptoms
The symptoms of psychosis are not fully understood but are generally believed to result from disrupted or altered brain activity. Psychosis symptoms are categorized into “positive” symptoms, such as hallucinations and delusions, and “negative” symptoms, which include memory impairment, disorganized thinking, lack of motivation, and an inability to feel pleasure. Patients often experience negative symptoms first, with positive symptoms emerging as the condition worsens.
Despite the shared experiences of symptoms, early and chronic cases of psychosis respond differently to treatment. Foster noted, “Studies show that patients have better prognoses if they get treatment early. Chronic psychosis has higher incidences of relapse, and available treatments do not work as well.”
Research Methodology and Findings
To address the gap in understanding the transition from early to chronic psychosis, Foster and Scheinost examined two large-scale open-source datasets. The Human Connectome Project Early Psychosis (HCP-EP) dataset contains information on early psychosis patients who presented symptoms within five years of data collection. The Strategic Research Program for Brain Sciences (SRPBS) Multi-disorder Connectivity dataset includes patients with varying levels of symptom severity.
The HCP-EP dataset included information for 107 participants, compared with data from 57 healthy participants. The SRPBS dataset contained information for 123 participants, compared with that of 99 healthy participants. The researchers used a machine learning model trained on functional magnetic resonance imaging data and symptom information to identify connectivity patterns in the brain that underpin psychosis symptoms.
The model successfully predicted positive and negative symptoms in both early and chronic psychosis groups, with stronger predictions for the chronic psychosis population due to a greater symptom burden. The study found that while psychosis arises from disruptions across the whole brain, the frontoparietal network plays a critical role in both early and chronic psychosis. This brain region is involved in cognitive flexibility, cognitive control, and coordinating behaviors.
Implications for Future Research and Treatment
According to Foster, negative symptoms may be linked to disruptions in the frontoparietal network. These findings provide a neurobiological reference point that could allow clinicians to track symptom-based brain networks as patients transition from early to chronic psychosis.
“If we can characterize brain differences to better understand symptoms, then we could potentially identify targets or biomarkers,” says Scheinost. “With more work, we might be able to predict transition points to monitor as you go along in treatment.”
Future research could focus on tracking patients over time to uncover how the identified brain networks change throughout the lifespan of psychosis. This approach could inform treatment options to improve care and prevent the worsening of symptoms.
For more information, refer to the study by Maya L. Foster et al., titled “Connectome-based predictive modeling of early and chronic psychosis symptoms,” published in Neuropsychopharmacology (2025). DOI: 10.1038/s41386-025-02064-9
🔗 **Fuente:** https://medicalxpress.com/news/2025-04-brain-networks-transition-early-chronic.html