Subtle subjective visual dysfunctions tied to poor outcomes in psychosis: Study
Germany: A recent study in Neuropsychopharmacology has shown that in patients with schizophrenia and recent-onset psychosis or who are at clinical high risk (CHR) for psychosis, subtle subjective visual dysfunctions (VisDys) are common and are tied to poorer outcomes.
Previous studies have reported the presence of subtle subjective visual dysfunctions in about 50% of patients with schizophrenia. They are suggested to predict psychosis states. The understanding of basic disease mechanisms mediating susceptibility to psychosis may be fostered by a deeper insight into VisDys, particularly in early psychosis states, thereby informing preventive interventions.
Against the above background, Johanna M. Schwarzer, Institute for Translational Psychiatry, University of Muenster, Muenster, Germany, and colleagues systematically examined the relationship between VisDys and core clinical measures across three early phase psychiatric conditions. Secondly, they used a novel multivariate pattern analysis approach for predicting VisDys by resting-state functional connectivity within relevant brain systems.
The researchers examined VisDys assessed with the Schizophrenia Proneness Instrument (SPI-A), resting-state fMRI data, and clinical measures in clinical high-risk states of psychosis (CHR, n = 143), recent-onset psychosis (ROP, n = 147), recent-onset depression (ROD, n = 151), and healthy controls (HC, n = 280).
In their multivariate pattern analysis approach, the researchers used pairwise functional connectivity within occipital (ON) and frontoparietal (FPN) networks implicated in visual information processing to predict VisDys.
The study led to the following findings:
- VisDys were reported more often in ROP (50.34%), and CHR (55.94%) than in ROD (16.56%), and HC (4.28%).
- Higher severity of VisDys was associated with less functional remission in both CHR and ROP, and, in CHR specifically, lower quality of life (Qol), higher depressiveness, and more severe impairment of visuospatial constructability.
- ON functional connectivity predicted the presence of VisDys in ROP (balanced accuracy 60.17%) and CHR (67.38%), while in the combined ROP + CHR sample VisDys were predicted by FPN (61.11%).
"Our findings suggest that VisDys are clinically highly relevant not only in recent-onset psychosis but especially in clinical high risk," the authors wrote, they are closely related to aspects of functional outcome, depressiveness, and Qol.
"Findings from multivariate pattern analysis support a model of functional integrity within ON and FPN driving the VisDys phenomenon and being implicated in core disease mechanisms of early psychosis states," they conclude.
Reference:
Schwarzer, J.M., Meyhoefer, I., Antonucci, L.A. et al. The impact of visual dysfunctions in recent-onset psychosis and clinical high-risk state for psychosis. Neuropsychopharmacol. (2022). https://doi.org/10.1038/s41386-022-01385-3
