Abstract
Subjects with ultra-high risk (UHR) states for psychosis show brain structural volume changes similar to first-episode psychosis and also elevated incidence of environmental risk factors like childhood trauma. It is unclear, however, whether early neurodevelopmental trajectories are altered in UHR. We screened a total of 12,779 first-year Chinese students to enroll 36 UHR subjects (based on clinical interviews) and 59 non-UHR healthy controls for a case-control study of markers of early neurodevelopment. Subjects underwent 3T MRI scanning and clinical characterization, including the childhood trauma questionnaire (CTQ). We then used the CAT12 toolbox to analyse structural brain scans for cortical surface complexity, a spherical harmonics-based marker of early neurodevelopmental changes. While we did not find statistically significant differences between the groups, a trend level finding for reduced cortical complexity (CC) in UHR vs. non-UHR subjects emerged in the left superior temporal cortex (and adjacent insular and transverse temporal cortices), and this trend level association was significantly moderated by childhood trauma (CTQ score). Our findings indicate that UHR subjects tend to show abnormal cortical surface morphometry, in line with recent research; more importantly, however, this association seems to be considerably modulated by early environmental impacts. Hence, our results provide an indication of environmental or gene × environment interactions on early neurodevelopment leading up to elevated psychosis risk.
Highlights
Psychotic disorders are often preceded by prodromal symptoms, leading to the construction of clinical criteria defining an “ultra-high risk” (UHR) status, which aims to facilitate early detection and intervention [1]
Subject recruitment was based on the psychometric screening of large cohorts of undergraduate (1st-year) Tongji University students, who first underwent screening using the prodromal questionnaire (PQ-16 or prodromal questionnaire-brief version (PQ-B)), identifying potential UHR subjects, who received a clinical interview [Semi-structured Interview for Psychosis risk Syndromes (SIPS)], and upon confirmation were invited to participate as UHR subjects, while otherwise healthy non-UHR subjects from the same population were randomly recruited from that screening cohort
This study provides first evidence of a moderating effect of childhood trauma on the emergence of subtle cortical folding abnormalities related to the UHR state for psychosis
Summary
Psychotic disorders are often preceded by prodromal symptoms, leading to the construction of clinical criteria defining an “ultra-high risk” (UHR) status, which aims to facilitate early detection and intervention [1]. Nearly 30% of individuals at UHR transit into psychosis within the Cortical Complexity, Childhood Trauma in UHR following 2 years, even non-transited UHR subjects might still suffer from continued attenuated psychotic-like symptoms and social functional impairment [6]. Maltreatment during childhood is strongly related to heightened social stress sensitivity [11], clinician-rated positive (but not negative) symptoms in at-risk youth [12] and occurrence and persistence of psychotic symptoms across the psychosis spectrum [13]. These findings suggest that childhood trauma might be an essential contributor to the development of psychosis.
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