Motor clusters reveal differences in risk for psychosis, cognitive functioning, and thalamocortical connectivity: evidence for vulnerability subtypes.

Dean, Derek J; Walther, Sebastian; Bernard, Jessica A; Mittal, Vijay A (2018). Motor clusters reveal differences in risk for psychosis, cognitive functioning, and thalamocortical connectivity: evidence for vulnerability subtypes. Clinical psychological science, 6(5), pp. 721-734. Sage 10.1177/2167702618773759

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Abnormal development of parallel cortical-striatal networks may contribute to abnormal motor, cognitive, and affective behavior prior to the onset of psychosis. Partitioning individuals at clinical high-risk (CHR) using motor behavior may provide a novel perspective on different etiological pathways or patient subtypes. A K-means cluster analysis was conducted in CHR (N=69; 42% female, mean age=18.67 years) young adults using theoretically distinct measures of motor behavior. The resulting subtypes were then compared on positive and negative symptoms at baseline, and 2-year risk of psychosis conversion. CHR participants were followed for 2 years to determine conversion to psychosis. CHR subtypes and healthy controls (N=61; 57% female, mean age=18.58 years) were compared on multiple cognitive domains and cortical-striatal connectivity. Results suggest 3 vulnerability subtypes of CHR individuals with different profiles of motor performance, symptoms, risk for conversion to psychosis, cognition, and thalamocortical connectivity. This approach may reflect a novel strategy for promoting tailored risk assessment as well as future research developing individualized medicine.

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