In a new fMRI study, a group of Finnish scientists were able to distinguish patients with first-episode psychosis from control subjects based on their brain activity while watching the movie “Alice in Wonderland” directed by Tim Burton.
Their findings will be presented at the 28th European College of Neuropsychopharmacology (ECNP) Conference in Amsterdam.
“In this work, we attempted to determine whether a person is a first-episode psychosis patient or a healthy control subject just by looking at their brain activity recorded during movie viewing,” said lead researcher Eva Rikandi of Aalto University, Helsinki, Finland.
“We found, that by monitoring activity in a region known as the precuneus we were able to distinguish patients from control subjects especially well. This would mean that the precuneus, a central hub for the integration of self- and episodic-memory-related information, plays an important role in this kind of information processing of psychotic patients.”
High-precision fMRI (functional Magnetic Resonance Imaging) is often used in neuroscience to locate brain activity in response to stimuli. These experiments often look at severely ill patients, such as those with repeated episodes of psychosis, and so the differences in brain activity would be easy to detect when compared to the general population.
However, early psychosis is more difficult to detect; the patterns in the brain are not as “hard wired” so the differences are more subtle when compared to control groups.
Researchers are also faced with the problem of trying to ensure that the patients and controls receive the same stimuli while undergoing measurement, so that the brains of the patients and the controls are concentrating on the same things while being scanned. Ideally, these stimuli should be involving and information-rich, like in a real-life situation.
The researchers came up with a creative solution: patients and controls were scanned while watching the movie “Alice in Wonderland,” which guaranteed that they were receiving the same information-rich stimulus.
Using a 3-Tesla MRI device, the scientists scanned the brains of 46 first-episode psychotic patients (meaning that they had only had one psychotic event) and 32 healthy controls, while watching the movie.
The findings showed significant differences within the precuneus region of the brain, a region connected with memory, visuospatial awareness, self-awareness, and aspects of consciousness.
“We were able to achieve almost 80 percent classification accuracy using these methods. This is the first study which directly associates the beginnings of psychosis with the precuneus, so it is now important that much more research is done in this area,” said Rikandi.
The researchers hope that this approach can lead to earlier screening and better diagnosis of at-risk populations.
“The interesting question here is how patients with psychosis, even in their first episode, process information in a different way,” said ECNP President-Elect, Professor Celso Arango.
“Specifically how a movie such as ‘Alice in Wonderland’ elicits the participation of different brain areas, and how that relate to the history of the person watching.”
“What we would like to know is if patients with psychosis might see this as more or less relevant to their own life than would healthy controls. This movie is about a fantasy world, would it be different with other types of movie?”