UCL Institute of Neurology


Neuropsychiatry Group: Brain abnormalities in psychosis

Professor Maria Ron

The Group’s focus is on the study of patients with first episode psychosis. This programme of research, in collaboration with Professor Eileen Joyce, aims to describe cognitive and brain structural phenotypes at illness onset in order to exclude the effects of aging, medication and other environmental factors.

The study funded by a programme grant from the Wellcome Trust, takes advantage of new imaging methodologies (MTR and diffusion tensor imaging [DTI]) able to detect subtle changes before volumetric changes become apparent. We have completed a 3 year follow-up study of first episode schizophrenia and a study of the corpus callosum using DTI. The follow-up study suggest that, although volumetric brain abnormalities are present at the onset of the disease, there is no conclusive evidence to suggest that they progress in these initial years. The lack of DTI abnormalities in the corpus callosum at this initial stage contrast with the myelin changes detected in chronic patients, suggesting that some neuropathological abnormalities may be progressive, or that they occur only in a subgroup of patients that go on to follow a chronic course.

In an attempt to examine neural correlates of cognition in psychosis we completed a study of patients with bipolar disorder (Professor Maria Ron and Dr Stefania Bruno in collaboration with Dr Lisa Cipolotti, Department of Clinical Neuropsychology, NHNN). BPII (Bipolar II) patients, in whom depressive episodes are prominent, had more severe deficits than BPI (Bipolar I) patients (with marked hypomania). IQ deficits correlated with reduction of MTR in the left temporal regions and with volume changes in frontal white matter.

In collaboration with Professor David Miller, we are looking at early imaging predictors of cognitive impairment in a cohort of patients recruited at onset of disease and now followed up for five years. Early prediction of cognitive deficits may allow more effective therapeutic interventions in the future. This study, which is funded by a programme grant from the MS Society, will continue for the next two years.