I first became interested in psychosis spectrum disorders during the first year of my PhD at University College London. I had read about the work of Dr Rick Adams, who was using computational tools to study schizophrenia, and decided to pursue a rotation project with him. During the rotation, I learnt that we can investigate brain function without the need for invasive procedures by using mathematical models. This is crucial for two key reasons. First, it allows us to study psychosis directly in patients, accounting for important factors that cannot be fully captured in animal models. Second, it is more directly applicable to clinical practice, and could contribute to the development of new interventions.
As I delved into psychosis research, I also had to navigate the difficult experience of watching a loved one struggle with this condition. I became acutely aware of the stigma faced by those affected by psychosis, the difficulties associated with finding the right treatment, and the lack of guidance available for patients and their families. Indeed, despite the progress we have made over the past few decades in improving the understanding and treatment of psychosis, many important questions remain. What biological changes underlie the onset and progression of psychosis? How can we intervene earlier to improve outcomes? Can we develop more effective treatments with fewer side effects?
My research tries to tackle these questions by investigating biological changes in the early stages of psychosis. Specifically, I study the balance between excitatory and inhibitory activity in the brain – essentially, how different brain cells communicate to enable signal transmission whilst maintaining stability. This balance is crucial for brain function. It is altered, for example, in epilepsy, and it is also thought to become disrupted in psychosis spectrum disorders. My work focuses on individuals who are at a higher risk of developing psychosis, either due to a genetic predisposition or to experiencing symptoms, like unexplained sensory perceptions or odd thoughts, which do not meet the severity or frequency criteria for a psychosis spectrum disorder but are linked to higher conversion rates. Studying these early changes is important because it can help us understand how psychosis develops. It may also make it possible for doctors to tailor treatments for at-risk individuals before symptoms become severe.
At the SIRS 2024 congress, I presented results from my PhD research showing that both excitatory and inhibitory activity become altered in emerging psychosis. Using computational models and EEG, which measures electrical activity in the brain via small sensors placed on the scalp, I found evidence that changes affecting excitatory cells could be a primary cause of the illness. My findings also showed that reduced inhibition in the brain may contribute to the severity of symptoms. This is promising because it suggests that we could target these alterations using glutamatergic treatments. These treatments are not currently available for schizophrenia, but they have shown encouraging results in preclinical studies and have the potential to improve negative and cognitive symptoms – such as lack of motivation and difficulties with memory and attention – which are not addressed by current dopaminergic medications.
While there is still much to learn, this represents a first step toward more effective early interventions. Indeed, ongoing research is needed – for instance, to validate and improve the models that we use – but I am hopeful that we can make a meaningful impact by continuing to research excitation and inhibition in at-risk individuals. Attending the SIRS conference as an Early Career Awardee provided me with opportunities to learn about other advances and to receive feedback that inspired new research directions. Looking to the future, our goal is to explore how early interventions can be tailored based on individual brain function, and to study how brain changes relate to the development of specific symptoms. I believe that incorporating artificial intelligence into this research holds great promise for improving our understanding and enhancing treatment outcomes.
Recently, my loved one found a treatment that works for him, and has published a book sharing his experiences to raise awareness and inspire others facing similar challenges. I submitted my PhD thesis, and am looking forward to continuing investigating mental health as a postdoctoral researcher. I am confident that, with continued research and collaboration, we can achieve a better understanding of psychosis and offer hope to those affected by this condition.