Risk of psychotic illness for immediate relatives of mentally ill

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People with psychotic illness and their immediate family members show similar changes in key areas of the brain, leading researchers to believe those first-degree relatives are genetically at-risk for mental illness.

A new study found that these brain changes represent a marker of genetic risk of developing psychotic illnesses, such as schizophrenia. Genetic markers could be targeted in the development of new treatments that may help to reduce the risk of developing psychotic illness.

The Genetic Risk

“First-degree relatives of people with psychosis are at increased genetic risk of developing a psychotic illness,” said Associate Professor Alex Fornito, Deputy Director of Monash Clinical and Imaging Neuroscience in the School of Psychology and Psychiatry at The University of Melbourne. “We found that people with psychosis and their unaffected first-degree relatives, who otherwise present no signs of illness, show similar brain changes [to each other] when compared to healthy people.”

Even at the earliest signs of illness, patients showed altered activity in a specific brain circuit that links the striatum to the prefrontal cortex. This circuit is key to attention, learning and memory. “The fact that we see the same brain changes in this group, in the absence of any overt signs of illness, points to a neural biomarker of rise of psychosis,” Fornito explained. “Patients who showed more severe changes in this circuit also showed more severe psychotic symptoms, providing a direct link between these brain changes and illness severity.”

They also found brain activity specific to the patients, but not their relatives. This change may reflect some kind of switch that determines whether a person transitions to mental illness. Fornito concluded:

We know that activity in brain circuits linking the striatum and prefrontal cortex are heavily influenced by the neurotransmitter dopamine, which is a major target for all medications currently used to treat psychosis. The difficulty is that these drugs have rather diffuse effects on the brain affecting many different systems. They also often have unpleasant side effects. Our findings point to a more specific treatment target. We are currently investigating whether we can selectively improve activity patterns in the affected brain circuits using non-invasive magnetic stimulation techniques. If successful, using these techniques in at-risk populations may help delay, minimize or prevent the impact of psychosis onset.

Source: MedicalNewsToday, Monash University

 
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