A Way of Predicting if New Psychosis Patients Will or Won’t Respond to Standard Treatment

This is cool not only because of the possibility they could stop with the trial and error, but because there’s a brain region that’s a biomarker for improvment in cognitive control. Other medications besides clozapine could be tested quicker by looking at that biomarker in early studies.

Participants were asked to perform a cognitive task involving pressing buttons while they were undergoing their fMRI scan. Results showed that psychosis patients with greater activation in the frontoparietal region during this task were more likely to show symptomatic improvement at their 1-year follow-up. Just as important, the test also showed that poor activation in the same brain circuitry corresponded with poor response to treatment.

Discovery of this fMRI brain signal raises the question of which treatments are most effective in increasing activation in the frontoparietal region.

The antipsychotic medicine clozapine has been shown to have the desired effect, but it is usually prescribed only for patients who are not helped by other medicines, due to its potentially dangerous side effects and need for constant monitoring. Other forms of treatment could be tested in the future for their impact on the signal.

The importance of the study, the team suggested, was in demonstrating the frontoparietal fMRI signal as an objective biomarker, implicating that region mechanistically in psychosis pathology and relating it to symptoms in psychosis patients.