The impact of visual dysfunctions in recent-onset psychosis and clinical high-risk state for psychosis

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Subtle subjective visual dysfunctions (VisDys) are reported by about 50% of patients with schizophrenia and are suggested to predict psychosis states. Deeper insight into VisDys, particularly in early psychosis states, could foster the understanding of basic disease mechanisms mediating susceptibility to psychosis, and thereby inform preventive interventions. We systematically investigated the relationship between VisDys and core clinical measures across three early phase psychiatric conditions. Second, we used a novel multivariate pattern analysis approach to predict VisDys by resting-state functional connectivity within relevant brain systems. VisDys assessed with the Schizophrenia Proneness Instrument (SPI-A), clinical measures, and resting-state fMRI data were examined in recent-onset psychosis (ROP, n = 147), clinical high-risk states of psychosis (CHR, n = 143), recent-onset depression (ROD, n = 151), and healthy controls (HC, n = 280). Our multivariate pattern analysis approach used pairwise functional connectivity within occipital (ON) and frontoparietal (FPN) networks implicated in visual information processing to predict VisDys. VisDys were reported more often in ROP (50.34%), and CHR (55.94%) than in ROD (16.56%), and HC (4.28%). Higher severity of VisDys was associated with less functional remission in both CHR and ROP, and, in CHR specifically, lower quality of life (Qol), higher depressiveness, and more severe impairment of visuospatial constructability. ON functional connectivity predicted presence of VisDys in ROP (balanced accuracy 60.17%, p = 0.0001) and CHR (67.38%, p = 0.029), while in the combined ROP + CHR sample VisDys were predicted by FPN (61.11%, p = 0.006). These large-sample study findings suggest that VisDys are clinically highly relevant not only in ROP but especially in CHR, being closely related to aspects of functional outcome, depressiveness, and Qol. Findings from multivariate pattern analysis support a model of functional integrity within ON and FPN driving the VisDys phenomenon and being implicated in core disease mechanisms of early psychosis states.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
Publication statusPublished - 18 Aug 2022

Bibliographical note

Funding Information:
The presented work was supported by the grant for the Personalized Prognostic Indicators for early Psychosis management (PRONIA Study): EU-FP7-HEALTH; agreement number: 602152. LK-I is a recipient of an NARSAD Young Investigator Award of the Brain & Behavior Research Foundation No. 28474. TL was additionally supported by the Koeln Fortune Program/Faculty of Medicine, University of Cologne. RL received additional funding from the European Unions Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement No. 734227. Open Access funding enabled and organized by Projekt DEAL.

Funding Information:
RU reports grants from the Medical Research Council, National Institute for Health Research: Health Technology Assessment, the National Institute of Mental Health, and personal fees from Sunovion, Springer Heathcare and Vitaris outside the submitted work. TL reports funding from Koeln Fortune Program/Faculty of Medicine, University of Cologne (No 370/2020) outside the submitted work. RL participated in advisory boards and received honoraria for talks presented at educational meetings organized by Janssen-Cilag, Otsuka/Lundbeck and ROVI outside the submitted work. No other conflicts of interest were reported.

Publisher Copyright:
© 2022, The Author(s).

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health


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