People with chronic psychosis may experience accelerated brain aging in two important cognitive networks, according to a new study published in the journal Biological Psychiatry.
One of these brain networks, called the frontoparietal network (FPN), was found to be normal in patients with early psychosis but reduced in those with chronic psychosis. This suggests that the decline happens after the illness has taken course. The other brain network with reduced efficiency is the cingulo-opercular network (CON).
The findings suggest that interventions designed to boost these brain networks after early signs of psychosis may help patients have better functional outcomes later in life.
“There is growing evidence that normal biological aging is accelerated in psychotic disorders. One aspect of healthy aging is declining cognitive function and less efficient communication within brain networks supporting cognitive abilities, including planning, problem solving, and memory,” said lead author Julia M. Sheffield, PhD, Vanderbilt University Medical Center.
The earliest signs of decline in healthy aging often involve communication within the FPN and CON networks. Therefore, the new findings suggest that psychosis patients experience normal patterns of brain aging — but at an accelerated rate.
For the study, the research team used brain imaging to compare the connectivity between brain regions — a measure of how efficiently the regions communicate — in 240 patients with psychotic disorder (including schizophrenia and psychotic bipolar disorder) and 178 healthy participants.
“The accelerated decline was specific to cognitive networks, providing evidence that accelerated aging is not due to a global reduction in efficient communication across the whole brain,” said Sheffield.
Specifically, patients with psychosis showed significantly reduced efficiency in the frontoparietal and subcortical networks, in comparison to healthy participants.
“The premature ‘aging’ or degeneration of cortical networks has been increasingly documented in association with schizophrenia,” said John Krystal, MD, Editor of Biological Psychiatry.
“However, we have very little insight into the underlying mechanisms. Linking these imaging findings to mechanism is a critical step to understanding the progression of schizophrenia so that we may disrupt it.”
In addition, since the network declines appear after the illness has already taken hold, there may be greater potential for disrupting this process.
“With advances in cognitive remediation and the positive impact of exercise on connectivity of these networks, our findings provide hope that young adults with recent onset psychosis will benefit from interventions bolstering connectivity within these networks, potentially slowing down or normalizing the rate of decline in efficiency and, therefore, cognitive function,” said Sheffield.
The new findings help researchers better understand how brain networks change over the course of psychotic disorders. The findings also suggest that targeting these networks could disrupt the accelerated rate of normal aging in people with early psychosis.