Imagine your brain is like a clock that ticks forward as you age. But for individuals with psychotic disorders like schizophrenia, their brains seem to be ticking ahead faster than expected. Researchers used advanced machine learning models to estimate the ‘brain-age’ of individuals with psychotic disorders compared to healthy controls and biological relatives. They found that regardless of specific diagnosis or illness severity, individuals with these disorders showed signs of having brains that were ‘older’ than their chronological age. This suggests that structural brain abnormalities in psychotic psychopathology may have a common origin during neurodevelopment rather than being a result of normal aging processes or degeneration. Not only did advanced brain-age relate to lower cognitive functioning, but it also showed links to subtle expressions associated with psychosis among biological relatives. This study highlights the importance of considering brain-age as an indicator of neurodevelopmental origins in psychotic disorders, opening up possibilities for early interventions and targeted treatments. Explore the underlying research here!

Schizophrenia is characterized by abnormal brain structure such as global reductions in gray matter volume. Machine learning models trained to estimate the age of brains from structural neuroimaging data consistently show advanced brain-age to be associated with schizophrenia. Yet, it is unclear whether advanced brain-age is specific to schizophrenia compared to other psychotic disorders, and whether evidence that brain structure is “older” than chronological age actually reflects neurodevelopmental rather than atrophic processes. It is also unknown whether advanced brain-age is associated with genetic liability for psychosis carried by biological relatives of people with schizophrenia. We used the Brain-Age Regression Analysis and Computation Utility Software (BARACUS) prediction model and calculated the residualized brain-age gap of 332 adults (163 individuals with psychotic disorders: 105 schizophrenia, 17 schizoaffective disorder, 41 bipolar I disorder with psychotic features; 103 first-degree biological relatives; 66 controls). The model estimated advanced brain-ages for people with psychosis in comparison to controls and relatives, with no differences among psychotic disorders or between relatives and controls. Specifically, the model revealed an enlarged brain-age gap for schizophrenia and bipolar disorder with psychotic features. Advanced brain-age was associated with lower cognitive and general functioning in the full sample. Among relatives, cognitive performance and schizotypal symptoms were related to brain-age gap, suggesting that advanced brain-age is associated with the subtle expressions associated with psychosis. Exploratory longitudinal analyses suggested that brain aging was not accelerated in individuals with a psychotic disorder. In sum, we found that people with psychotic disorders, irrespective of specific diagnosis or illness severity, show indications of non-progressive, advanced brain-age. These findings support a transdiagnostic, neurodevelopmental formulation of structural brain abnormalities in psychotic psychopathology.

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