title: Neuroimaging Biomarkers for Psychosis.
abstract: BACKGROUND
  Biomarkers provide clinicians with a predictable model for the diagnosis, treatment and follow-up of medical ailments. Psychiatry has lagged behind other areas of medicine in the identification of biomarkers for clinical diagnosis and treatment. In this review, we investigated the current state of neuroimaging as it pertains to biomarkers for psychosis.
  
  
  METHODS
  We reviewed systematic reviews and meta-analyses of the structural (sMRI), functional (fMRI), diffusion-tensor (DTI), Positron emission tomography (PET) and spectroscopy (MRS) studies of subjects at-risk or those with an established schizophrenic illness. Only articles reporting effect-sizes and confidence intervals were included in an assessment of robustness.
  
  
  RESULTS
  Out of the identified meta-analyses and systematic reviews, 21 studies met the inclusion criteria for assessment. There were 13 sMRI, 4 PET, 3 MRS, and 1 DTI studies. The search terms included in the current review encompassed familial high risk (FHR), clinical high risk (CHR), First episode (FES), Chronic (CSZ), schizophrenia spectrum disorders (SSD), and healthy controls (HC).
  
  
  CONCLUSIONS
  Currently, few neuroimaging biomarkers can be considered ready for diagnostic use in patients with psychosis. At least in part, this may be related to the challenges inherent in the current symptom-based approach to classifying these disorders. While available studies suggest a possible value of imaging biomarkers for monitoring disease progression, more systematic research is needed. To date, the best value of imaging data in psychoses has been to shed light on questions of disease pathophysiology, especially through the characterization of endophenotypes.
authors.affiliation: Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, 75 Fenwood Road, 5th Floor, Boston, MA 02115 USA (617) 754-1244.
authors.forename: Brandon M
authors.initials: BM
authors.lastname: Hager
authors.affiliation: Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, 75 Fenwood Road, 5th Floor, Boston, MA 02115 USA (617) 754-1256.
authors.forename: Matcheri S
authors.initials: MS
authors.lastname: Keshavan
keywords: MRS; PET; fMRI; neuroimaging biomarkers; psychosissMRI