What brain regions are involved in causing psychotic symptoms? Take a moment away from the existential dread about the future of science, and join me in this summary of some incredibly cool stuff that could help patients! 1/n🧵 - ThreadSky

andrewpines.bsky.social • 15 days ago

What brain regions are involved in causing psychotic symptoms?

Take a moment away from the existential dread about the future of science, and join me in this summary of some incredibly cool stuff that could help patients!
1/n🧵

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saavabrian.bsky.social•14 days ago

What a thread!

andrewpines.bsky.social•14 days ago

Thanks for reading it!

raphaeljbrito.bsky.social•13 days ago

Very exciting findings!

andrewpines.bsky.social•13 days ago

Thank you!

andrewpines.bsky.social•15 days ago

First, some background: psychosis is a syndrome of hallucinations, delusions, disorganized thought. Chronic symptoms are diagnosed as schizophrenia.
Antipsychotic medications are not always effective and often cause intolerable side effects. Talk to anyone who takes them - we need better treatment.

andrewpines.bsky.social•15 days ago

Transcranial magnetic stimulation (TMS) is a promising alternative - it has few side effects, is safe in patients with schizophrenia, and is FDA-cleared for other neuropsychiatric disorders (Depression, addiction, OCD).
But past schizophrenia TMS trials have had mixed results...

andrewpines.bsky.social•15 days ago

TMS trials for schizophrenia have primarily targeted brain abnormalities correlated with schizophrenia, which could represent spurious or compensatory processes. Here, we hypothesized that defining a TMS target for schizophrenia based on lesions that cause psychosis could improve outcomes.

andrewpines.bsky.social•15 days ago

First, we systematically reviewed the literature and found 153 cases of lesions that cause psychosis (meaning the symptoms developed acutely after the lesion, the individual has no history of psychosis, and there was clear evidence distinguishing the psychosis from other conditions like delirium).

andrewpines.bsky.social•15 days ago

Then, we manually traced all of these lesions onto an MNI template. Using a large normative connectome (n=1000), we computed the functional connectivity of each lesion.

andrewpines.bsky.social•15 days ago

We then performed two tests: where these connections overlap and which connections are specific relative to >1000 lesions not associated with psychosis. These tests converged on the posterior aspect of the hippocampus, closely aligning with the subiculum (FWE-corrected p<0.0005.)

esolomon.bsky.social•14 days ago

This was a great paper! I'm getting a study off the ground shortly looking at TMS to cortical targets with strong FC to hippocampus in schizophrenia. Your work really helped solidify the argument!

andrewpines.bsky.social•14 days ago

Thank you - really loved your recent paper on iEEG signal from TMS. Exciting that these results converge with something you’re working on!

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