The Clinical High Risk (CHR) phase of schizophrenia is the period of imminent risk for psychosis when cognitive and social functioning begin to decline. The CHR phase typically occurs during adolescence extending into young adulthood, a time period when major changes in the brain’s structural and functional organization support cognitive and behavioral development. Disruptions in these processes may give rise to brain and neurocognitive abnormalities and, ultimately, conversion to psychosis. In this symposium, we examine the neurobiology of conversion using multimodal imaging data from a unique sample of medication-naïve adolescents and young adults who meet criteria for CHR, and age- and gender-matched healthy controls (HC). This sample was acquired as part of the SHARP (Shanghai At-Risk for Psychosis) study, a longitudinal NIMH-funded research program developed at the Shanghai Mental Health Center in collaboration with a multidisciplinary Harvard/MIT research team. In four presentations, we will report on different imaging data acquired in the SHARP sample, including structural MRI, diffusion-weighted MRI, resting-state fMRI, and event related potentials. Together, the findings provide important preliminary insights into the neurobiology of conversion as documented by structural, functional and neurophysiological brain changes in CHR relative to HC, with some changes occurring in CHRs who converted to psychosis but not in those who did not. Discussant Martha Shenton, a leading international expert on neuroimaging in schizophrenia, will conclude the session by interpreting the findings presented in our symposium into the broader schizophrenia literature and moderating a discussion on brain changes taking place in the transition to psychosis.
