Glutamate changes as a new neurocognitive marker in psychosis

Interventions aiming to improve cognitive functioning in psychosis are beneficial for some individuals but not others. Differences in treatment outcomes could be linked to underlying neurotransmitter systems. If functional changes in glutamate levels could predict neurocognitive treatment outcomes, it would become possible to personalise these cognitive interventions. With a reliable marker, beneficial treatments could be selected earlier. Differences in cognitive impairments in psychosis are linked to alterations in neurotransmitters like glutamate. Our goal is to understand the potential of task-induced changes in glutamate as a marker for treatment outcomes in individuals with first-episode psychosis. We will measure alterations in brain glutamate levels with functional magnetic resonance spectroscopy (fMRS) while participants complete a cognitive task. Then, we will examine if glutamate changes can predict the cognitive effects of non-invasive brain stimulation, known to influence glutamate levels. Simultaneously, we will work with lived experience experts to understand their view on cognitive impairments and personalised treatment options involving brain imaging and stimulation. Our findings will provide a strong basis for a larger intervention study aiming to optimise brain stimulation parameters and to cross-validate glutamate as predictor of treatment effects. Our qualitative data will identify potential barriers to the uptake of these options.