According to a new study by Vanderbilt researchers, normal brain aging patterns in patients with a psychotic disorder occur at an accelerated rate, impacting the patient’s cognitive functioning and suggesting treatment intervention in the early psychosis period may improve long-term outcomes.
The study, published in Biological Psychiatry, used brain imaging techniques to compare the degree of interconnectivity between brain regions in patients with psychosis and healthy control subjects. Researchers specifically looked at connectivity in the frontoparietal network and cingulo-opercular network, both of which support general cognition and exhibit the earliest signs of age-related decline in healthy individuals.
The results indicated that these networks were intact in patients with early-stage psychosis, but showed a more rapid decline in patients with chronic psychosis when compared with healthy individuals of the same age range.
The study also examined the visual and subcortical networks — neither of which showed relationships with cognitive functioning — to determine whether a decline is seen in other brain networks that are less susceptible to aging effects. Neither of these networks showed evidence of accelerated aging, suggesting specificity for cognitive networks.
Julia Sheffield, PhD, a psychosis emphasis postdoctoral fellow in the Department of Psychiatry and Behavioral Sciences and lead investigator for the study, hoped the research would shed light on why patients with psychosis experience a decline in so many areas of cognition.
“Unlike in diseases such as Alzheimer’s where you see specific memory deficits first, and attention deficit hyperactivity disorder (ADHD) where executive functioning is most affected, patients with psychosis see a reduction in all cognitive functioning,” said Sheffield, adding that memory, processing speed and verbal fluidity are all impacted.
Evidence of accelerated aging of cognitive function has also been found in depression, raising the need for a greater understanding of whether the decline is caused by physical brain changes due to disease progression or a factor common across mental illnesses, such as prolonged stress.
Understanding that these functions begin to decline in early psychosis allows for earlier treatment interventions, which may help patients maintain their level of cognition. Physical exertion, reducing stress levels and maintaining a healthy lifestyle have all proven to help with healthy brain aging. Cognitive training exercises offered through computer programs can also target specific cognitive functions, helping strengthen memory, planning and executive function.
“This study demonstrates that even though a patient may have a diagnosis of a psychotic disorder, we can still intervene early to help maintain their brain’s health,” said Sheffield.
“Patients in the early stages of psychosis have hope that their cognitive ability doesn’t have to decline to the degree we’ve historically seen in chronic patients. That’s exciting, because schizophrenia is often seen as a disease that can’t be easily overcome. Being able to tell patients and families that the patient’s brain is healthier than we would’ve initially thought and providing them with tools to continue on that trajectory gives them hope.”
This research was supported by the Charlotte and Donald Test Fund and by the National Institute of Mental Health.
Other VUMC contributors include Baxter Rogers, PhD, Jennifer Blackford, PhD, Stephan Heckers, MD, MSc, and Neil Woodward, PhD.
