Emerging temporal lobe dysfunction in people at clinical high risk for psychosis

TY - JOUR

T1 - Emerging temporal lobe dysfunction in people at clinical high risk for psychosis

AU - Allen, Paul

AU - Moore, Holly

AU - Corcoran, Cheryl

AU - Gilleen, James

AU - Kozhuharova, Petya

AU - Reichenberg, Avi

AU - Malaspina, Dolores

PY - 2019/5/13

Y1 - 2019/5/13

N2 - Clinical high-risk (CHR) individuals are being assessed to investigate the prodromal phases of psychosis and progression to illness. Research has identified the importance of medial and lateral temporal lobe abnormalities as central to the emergence of two key pathognomic symptom clusters in psychosis. Dysfunction in the medial temporal lobe, particularly the hippocampus, is linked to dysregulation of glutamate and dopamine via a hippocampal-striatal-midbrain network which may lead to aberrant signalling of salience that may underpin the formation of delusions. Similarly, lateral temporal and fronto-temporal dysfunction is linked to the disorganized speech and language impairments observed in CHR populations, the severity of which is associated with the conversion to psychosis among CHR cases. Here, we summarize the significance of these findings in terms of emergent symptoms and transition to psychosis and symptomatology in CHR populations. We propose key questions for future work with the aim to identify the neural mechanisms of transition.© 2019, The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/

AB - Clinical high-risk (CHR) individuals are being assessed to investigate the prodromal phases of psychosis and progression to illness. Research has identified the importance of medial and lateral temporal lobe abnormalities as central to the emergence of two key pathognomic symptom clusters in psychosis. Dysfunction in the medial temporal lobe, particularly the hippocampus, is linked to dysregulation of glutamate and dopamine via a hippocampal-striatal-midbrain network which may lead to aberrant signalling of salience that may underpin the formation of delusions. Similarly, lateral temporal and fronto-temporal dysfunction is linked to the disorganized speech and language impairments observed in CHR populations, the severity of which is associated with the conversion to psychosis among CHR cases. Here, we summarize the significance of these findings in terms of emergent symptoms and transition to psychosis and symptomatology in CHR populations. We propose key questions for future work with the aim to identify the neural mechanisms of transition.© 2019, The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/

KW - schizophrenia

KW - Clinical high-risk

KW - hippocampus

KW - Temporal Lobe

U2 - 10.3389/fpsyt.2019.00298

DO - 10.3389/fpsyt.2019.00298

M3 - Article

SN - 1664-0640

VL - 10

JO - FRONTIERS IN PSYCHIATRY

JF - FRONTIERS IN PSYCHIATRY

IS - 298

ER -