A recent study utilized neuroimaging techniques and advanced computational algorithms to precisely identify the two primary cerebral areas implicated in the manifestation of psychosis. 

Recent neuroimaging data obtained from individuals with psychosis may provide empirical evidence supporting a longstanding hypothesis regarding the underlying cause of these abrupt departures from reality.

According to the theory, during psychosis, the brain networks responsible for regulating a person's attention experience a malfunction. It leads to individuals experiencing hallucinations, which are perceptions of things that are not occurring, and delusions, which are firmly held incorrect beliefs. Psychosis is a characteristic of severe mental illnesses like schizophrenia. However, its symptoms can also be present on a spectrum and can occur without being associated with any specific mental disorder.

Scientists have long struggled to uncover the precise mechanisms in the brain that lead to psychosis. One factor contributing to this is that psychosis is frequently examined in individuals who have been on antipsychotic medications for an extended period, making it challenging to differentiate between brain alterations associated with the disorder and those associated with the medicines.

The objective of the recent brain scan study was to precisely identify the fundamental mechanisms associated with psychosis starting from a young age. It could potentially facilitate earlier detection and improve the effectiveness of therapies.

The study looked for these anomalies in those aged 6 to 39 who had 22q11.2 deletion syndrome, a rare genetic disorder linked to psychosis. Part of one chromosomal 22 copies in those with the disorder is absent. Those with the syndrome have about a 30% chance of developing psychosis, schizophrenia, or both, in addition to other disorders, including heart irregularities, attention-deficit/hyperactivity disorder (ADHD), and autism.

The team acquired brain data utilizing functional magnetic resonance imaging (fMRI), a technique that monitors alterations in blood flow that correlate with brain cell activity. Approximately 900 individuals participated in the study. One hundred-one had 22q11.2 deletion syndrome; some had psychosis, and some did not. Additionally, 120 had "psychosis of unknown origin."

Furthermore, the study incorporated individuals without any prior instances of psychosis for comparison. Additionally, the study included individuals with ADHD and autism. With assistance from computer science colleagues at Stanford, the researchers developed a novel machine learning technique to detect patterns in the fMRI data. The method identified overlapping "signatures" in the brains of individuals diagnosed with 22q11.2 deletion syndrome and accompanying psychosis, as well as those with psychosis of unknown etiology.

The fingerprints, absent in all comparison groups without psychosis, were detected in two crucial components of the brain's "salience network." The primary function of this network is to flexibly shift our focus between internal cognition and external sensory inputs, effectively guiding our attention towards significant and tangible information. The brain scans indicate that the anterior insula and ventral striatum are the two most vital nodes in this network for psychosis. The anterior insula functions to eliminate irrelevant information, while the ventral striatum predicts which information will be most rewarding or significant to us.

The researchers intend to focus on these two crucial brain regions using established therapies, such as brain stimulation, to determine whether they can hinder or postpone the onset of psychosis in those who are at a heightened risk of developing the disorder. Additionally, they intend to investigate the impact of antipsychotic drugs on various components of the salience network to uncover their precise mechanisms of action.

Article source: Molecular psychiatry

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