Longitudinal Development of Neurocognitive Functioning and Gray Matter Volume in Youths With Recurrent Psychosis Spectrum Symptoms

Schizophr Bull. 2025 May 18:sbaf049. doi: 10.1093/schbul/sbaf049. Online ahead of print.

ABSTRACT

BACKGROUND AND HYPOTHESIS: Neurodevelopmental risk-factor models of psychosis highlight the importance of early developmental deviations in the emergence of psychosis. However, few longitudinal studies map neurodevelopment and neurocognitive trajectories across age in preclinical psychosis. We investigated longitudinal trajectories in neurocognition and brain volume in a community cohort of adolescents with recurrent psychosis spectrum (PS) symptoms, tracking their development into young adulthood compared to their typically developing (TD) peers.

STUDY DESIGN: Utilizing the Philadelphia Neurodevelopmental Cohort, we analyzed data of 231 youths aged 8-30 with at least one follow-up assessment, including 88 with PS.

STUDY RESULTS: Individuals with PS showed similar developmental trajectories but demonstrated significant impairments in executive functioning (t = -2.81, q = 0.010), memory (t = -2.34, q = 0.019), complex cognition (t = -3.72, q = 0.001), social cognition (t = -2.73, q = 0.010), motor (t = -2.50, q = 0.015), and general cognition (t = -3.20, q = 0.004). Lower cortical (t = -2.46, P = .014) and subcortical (t = -2.41, P = .016) gray matter volume in the recurrent PS group compared to the TD group were documented with age-related group differences becoming less pronounced by young adulthood. Further analyses revealed age-by-group interactions (qs < 0.05) observed in a few temporal and frontal regions, with differences between groups at earlier ages.

CONCLUSIONS: These findings suggest that recurrent PS symptoms are linked to early neurocognitive and brain structure deficits, highlighting the need for interventions to reduce psychosis risk and support healthy neurodevelopment.

PMID:40382716 | DOI:10.1093/schbul/sbaf049