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Synaptic density deficits in patients with a psychotic disorder and unaffected siblings

Van der Weijden-Germann, M.; de Jager, J. E.; Nuninga, J. O.; de Vries, E. F. J.; van der Weijden, C. W. J.; Sommer, I. E. C.

2025-06-06 psychiatry and clinical psychology
10.1101/2025.06.05.25328865 medRxiv
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BackgroundSchizophrenia spectrum disorders (SSD) are associated with cognitive dysfunction, which has been linked to excessive synaptic pruning. To disentangle SSDs genetic vulnerability from secondary effects, we investigated synaptic density in individuals with SSD, unaffected siblings of individuals with SSD, and healthy controls (HC). MethodsWe recruited 24 SSD individuals, 25 unaffected siblings, and 26 HC. Participants underwent cognitive assessments using the Brief Assessment of Cognition in Schizophrenia and symptom severity in individuals with SSD was assessed with the Positive and Negative Syndrome Scale. Synaptic density was measured using [11C]UCB-J PET., with binding potential (BPND) calculated across multiple a priori chosen regions of interest (ROIs). Group differences in BPND and associations with cognition and symptoms were assessed using multiple linear regression and correlation. ResultsSSD individuals had significant lower cognitive functioning and reduced [11C]UCB-J BPND in frontal, temporal, and limbic regions, including the hippocampus, amygdala, superior temporal gyrus, insula, and inferior frontal gyrus, compared to HC. Siblings exhibited preserved cognitive performance but displayed significant BPND reductions in overlapping regions as SSD individuals, including the hippocampus, amygdala, and superior temporal gyrus, relative to HC. Across all participants, verbal memory performance correlated with BPND in the left superior frontal gyrus, precentral gyrus, and right middle frontal gyrus. Motor speed was associated with BPND in the cerebellum. ConclusionDespite deficits in synaptic density, siblings maintained intact cognitive performance, suggesting compensatory mechanisms. Our findings support a relationship between synaptic pathology, genetic liability, and cognitive resilience, which may inform targeted interventions for SSD.

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