# Brain texture alterations predict subtle visual perceptual dysfunctions in recent onset psychosis and clinical high-risk state **Authors:** Rebekka Lencer, Andreas Sprenger, Inga Meyhöfer, Udo Dannlowski, Georg Romer, Lana Kambeitz-Ilankovic, Joseph Kambeitz, Theresa Lichtenstein, Marlene Rosen, Stephan Ruhrmann, Shalaila S. Haas, Raimo K. R. Salokangas, Christos Pantelis, Carolina Bonivento, Frauke Schultze-Lutter, Eva Meisenzahl, Paolo Brambilla, Alessandro Bertolino, Rachel Upthegrove, Christos Davatzikos, Nikolaos Koutsouleris, Stefan Borgwardt, Christina Andreou, Alexandra Korda, Raimo K. R. Salokangas, Raimo K. R. Salokangas, Alessandro Bertolino, Nikolaos Koutsouleris, Anne Ruef, Lisa Hahn, Dominic B. Dwyer, Shalaila Haas, Linda A. Antonucci, Alkomiet Hasan, Claudius Hoff, Ifrah Khanyaree, Aylin Melo, Susanna Muckenhuber-Sternbauer, Yanis Köhler, Ömer Öztürk, Nora Penzel, David Popovic, Adrian Rangnick, Sebastian von Saldern, Rachele Sanfelici, Moritz Spangemacher, Ana Tupac, Maria Fernanda Urquijo-Castro, Johanna Weiske, Antonia Wosgien, Camilla Krämer, Lana Kambeitz-Ilankovic, Joseph Kambeitz, Julian Wenzel, Stephan Ruhrmann, Karsten Blume, Dennis Hedderich, Dominika Julkowski, Nathalie Kaiser, Thorsten Lichtenstein, Ruth Milz, Alexandra Nikolaides, Tanja Pilgram, Mauro Seves, Martina Wassen, Christina Andreou, Stefan Borgwardt, André Schmidt, Anita Riecher-Rössler, Laura Egloff, Fabienne Harrisberger, Ulrike Heitz, Claudia Lenz, Letizia Leanza, Amatya Mackintosh, Renata Smieskova, Erich Studerus, Anna Walter, Sonja Widmayer, Stephen J. Wood, Rachel Upthegrove, Paris Alexandros Lalousis, Chris Day, Sian Lowri Griffiths, Mariam Iqbal, Mirabel Pelton, Pavan Mallikarjun, Alexandra Stainton, Ashleigh Lin, Jarmo Hietala, Alexander Denissoff, Anu Ellilä, Tiina From, Markus Heinimaa, Tuula Ilonen, Päivi Jalo, Heikki Laurikainen, Antti Luutonen, Akseli Mäkela, Janina Paju, Henri Pesonen, Reetta-Liina Säilä, Anna Toivonen, Otto Turtonen, Frauke Schultze-Lutter, Eva Meisenzahl, Alexandra Korda, Susanne Neufang, Christian Schmidt-Kraepelin, Henrik Rohner, Sonja Botterweck, Norman Kluthausen, Gerald Antoch, Julian Caspers, Hans-Jörg Wittsack, Pierluigi Selvaggi, Giuseppe Blasi, Giulio Pergola, Grazia Caforio, Leonardo Fazio, Tiziana Quarto, Barbara Gelao, Raffaella Romano, Ileana Andriola, Andrea Falsetti, Marina Barone, Roberta Passiatore, Marina Sangiuliano, Rebekka Lencer, Marian Surmann, Olga Bienek, Udo Dannlowski, Ana Beatriz Solana, Manuela Abraham, Timo Schirmer, Paolo Brambilla, Carlo Altamura, Marika Belleri, Francesca Bottinelli, Adele Ferro, Marta Re, Emiliano Monzani, Maurizio Sberna, Giampaolo Perna, Maria Nobile, Alessandra Alciati, Armando D’Agostino, Lorenzo Del Fabro, Matteo Balestrieri, Carolina Bonivento, Giuseppe Cabras, Franco Fabbro, Marco Garzitto, Sara Piccin, Christos Pantelis, Christos Davatzikos PMC · DOI: 10.1038/s41398-026-03840-x · 2026-02-12 ## TL;DR This study shows that brain texture changes can predict subtle visual perceptual issues in early psychosis and high-risk individuals. ## Contribution The study introduces brain texture features as a novel predictor of visual perceptual dysfunction in early psychosis and clinical high-risk states. ## Key findings - Brain texture features predicted visual perceptual dysfunction with over 77% accuracy in recent onset psychosis. - The prediction models also showed 64% accuracy in clinical high-risk samples and 50% in recent onset depression. - Brain features were significantly linked to symptom severity and psychosocial functioning scores. ## Abstract Deeper understanding of Subtle Visual Dysfunctions (VisDys) in the early stage of mental illness and their neurobiological underpinnings, as reflected by microstructural brain texture features, could advance our understanding of the underlying disease perceptual mechanisms that mediate susceptibility to psychosis. In this study, we aim a) to investigate the utility of brain texture features for the prediction of VisDys in recent onset psychosis (ROP) and clinical high-risk syndromes for psychosis (CHR-P), respectively, b) to test prediction models established in ROP and CHR-P in an independent validation sample with recent onset depression (ROD) diagnoses and c) to test for symptom expression related brain features associated with VisDys. sMRI were acquired in a training sample including 128 ROP (67 patients with VisDys), 134 CHR-P (71 patients with VisDys). Independent validation sets included 46 ROP (19 with VisDys), 124 CHR-P (68 patients with VisDys) and a sample of 256 ROD (50 patients with VisDys). Both classification schemas in ROP and CHR-P presented balanced accuracy >77% and >64% in the independent validation samples of ROP, CHR-P, and ROD, respectively. Statistically significant associations were identified with scores from the Positive and Negative Symptom Scale, psychosocial functioning, and the Scale of Negative Symptoms. ## Linked entities - **Diseases:** psychosis (MONDO:0005485), depression (MONDO:0002050) ## Full-text entities - **Diseases:** ROD (MESH:D003866), CHR-P (MESH:D011618), mental illness (MESH:D001523), VisDys (MESH:D014786) - **Species:** Homo sapiens (human, species) [taxon 9606] ## Figures 6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12923831/full.md --- Source: https://tomesphere.com/paper/PMC12923831