Delusion
delusion
Integration of 3D human stem cell models derived from post-mortem tissue and statistical genomics to guide schizophrenia therapeutic development
Schizophrenia is a neuropsychiatric disorder characterized by positive symptoms (such as hallucinations and delusions), negative symptoms (such as avolition and withdrawal) and cognitive dysfunction1. Schizophrenia is highly heritable, and genetic studies are playing a pivotal role in identifying potential biomarkers and causal disease mechanisms with the hope of informing new treatments. Genome-wide association studies (GWAS) identified nearly 270 loci with a high statistical association with schizophrenia risk; however each locus confers only a small increase in risk therefore it is difficult to translate these findings into understanding disease biology that can lead to treatments. Induced pluripotent stem cell (iPSC) models are a tractable system to translate genetic findings and interrogate mechanisms of pathogenesis. Mounting research with patient-derived iPSCs has proposed several neurodevelopmental pathways altered in SCZ, such as neural progenitor cell (NPC) proliferation, imbalanced differentiation of excitatory and inhibitory cortical neurons. However, it is unclear what exactly these iPS models recapitulate, how potential perturbations of early brain development translates into illness in adults and how iPS models that represent fetal stages can be utilized to further drug development efforts to treat adult illness. I will present the largest transcriptome analysis of post-mortem caudate nucleus in schizophrenia where we discovered that decreased presynaptic DRD2 autoregulation is the causal dopamine risk factor for schizophrenia (Benjamin et al, Nature Neuroscience 2022 https://doi.org/10.1038/s41593-022-01182-7). We developed stem cell models from a subset of the postmortem cohort to better understand the molecular underpinnings of human psychiatric disorders (Sawada et al, Stem Cell Research 2020). We established a method for the differentiation of iPS cells into ventral forebrain organoids and performed single cell RNAseq and cellular phenotyping. To our knowledge, this is the first study to evaluate iPSC models of SZ from the same individuals with postmortem tissue. Our study establishes that striatal neurons in the patients with SCZ carry abnormalities that originated during early brain development. Differentiation of inhibitory neurons is accelerated whereas excitatory neuronal development is delayed, implicating an excitation and inhibition (E-I) imbalance during early brain development in SCZ. We found a significant overlap of genes upregulated in the inhibitory neurons in SCZ organoids with upregulated genes in postmortem caudate tissues from patients with SCZ compared with control individuals, including the donors of our iPS cell cohort. Altogether, we demonstrate that ventral forebrain organoids derived from postmortem tissue of individuals with schizophrenia recapitulate perturbed striatal gene expression dynamics of the donors’ brains (Sawada et al, biorxiv 2022 https://doi.org/10.1101/2022.05.26.493589).
A predictive-processing account of psychosis
There has been increasing interest in the neurocomputational mechanisms underlying psychotic disorders in recent years. One promising approach is based on the theoretical framework of predictive processing, which proposes that inferences regarding the state of the world are made by combining prior beliefs with sensory signals. Delusions and hallucinations are the core symptoms of psychosis and often co-occur. Yet, different predictive-processing alterations have been proposed for these two symptom dimensions, according to which the relative weighting of prior beliefs in perceptual inference is decreased or increased, respectively. I will present recent behavioural, neuroimaging, and computational work that investigated perceptual decision-making under uncertainty and ambiguity to elucidate the changes in predictive processing that may give rise to psychotic experiences. Based on the empirical findings presented, I will provide a more nuanced predictive-processing account that suggests a common mechanism for delusions and hallucinations at low levels of the predictive-processing hierarchy, but still has the potential to reconcile apparently contradictory findings in the literature. This account may help to understand the heterogeneity of psychotic phenomenology and explain changes in symptomatology over time.
The Social Brain: From Models to Mental Health
Given the complex and dynamic nature of our social relationships, the human brain needs to quickly learn and adapt to new social situations. The breakdown of any of these computations could lead to social deficits, as observed in many psychiatric disorders. In this talk, I will present our recent neurocomputational and intracranial work that attempts to model both 1) how humans dynamically adapt beliefs about other people and 2) how individuals can exert influence over social others through model-based forward thinking. Lastly, I will present our findings of how impaired social computations might manifest in different disorders such as addiction, delusion, and autism. Taken together, these findings reveal the dynamic and proactive nature of human interactions as well as the clinical significance of these high-order social processes.