How Brain Dysfunction Fuels Hallucinations and Delusions in Psychosis

Inside the brains of people with psychosis, two key systems are malfunctioning: a “filter” that directs attention toward important external events and internal thoughts, and a “predictor” that anticipates rewards. When these systems go haywire, it becomes difficult for the person to distinguish what’s real from what’s not, resulting in hallucinations and delusions.

Tracing Psychosis from Childhood to Adulthood

The findings come from a Stanford Medicine-led study that used brain scans to examine the development of psychosis in young people with a rare genetic condition called 22q11.2 deletion syndrome. This syndrome carries a 30% risk of psychosis or schizophrenia, making it an ideal model for understanding the underlying brain mechanisms.

Identifying the Brain’s Psychosis Fingerprint

The researchers used machine learning algorithms to analyze brain scans from individuals with 22q11.2 deletion syndrome, both with and without psychosis. They found that the anterior insula, a key part of the brain’s “filtering” system, and the ventral striatum, the “reward predictor,” were the areas most affected in those experiencing psychosis. Interestingly, these same brain patterns were observed in people with psychosis of unknown origin, suggesting a common neural signature for the condition.

Potential for Earlier Intervention

The study’s findings hold promise for earlier detection and prevention of psychosis. The researchers believe that targeting the malfunctioning brain regions with interventions like transcranial magnetic stimulation or focused ultrasound could potentially delay or even prevent the onset of schizophrenia and other psychotic disorders.

A Call for Empathy and Understanding

The researchers emphasize the importance of approaching people with psychosis with compassion. They hope their work will not only advance scientific understanding but also inspire a cultural shift towards greater empathy and support for those experiencing this challenging condition.

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