A SUBTLE shift in brain ageing may already be present in young adults who experience psychotic experiences, according to new longitudinal research.
Early Psychotic Experiences and Brain Development
Hallucinations and delusions, collectively known as psychotic experiences, are relatively common in the general population and often occur without a diagnosed psychiatric disorder. While previous research has linked these experiences to structural brain differences, their relationship to brain ageing has remained uncertain. Brain age is estimated using MRI scans and machine learning to predict how old a brain appears compared with a person’s actual age, producing a brain age gap. A higher gap suggests atypical brain maturation. Understanding whether psychotic experiences are associated with altered brain ageing could offer insight into early neurodevelopmental vulnerability before the onset of clinical psychosis.
MRI Analysis Reveals Brain Age Gap At 20 Years
Researchers analysed brain scans from the Avon Longitudinal Study of Parents and Children using a multilayer perceptron model trained on 2628 MRI scans from individuals aged 6–50 years. Participants were scanned at around age 20, and again at around age 30. At age 20, individuals reporting psychotic experiences showed a significantly larger brain age gap than controls, with a Cohen’s d of 0.70 (95% CI, 0.14 to 1.27; p = .014; q = .029). Brain age also showed a linear association with symptom severity, increasing by 1.34 ± 0.68 years per severity level (p = .049; q = .098). By age 30, the difference between groups had narrowed to 0.22 ± 0.15 years and was no longer statistically significant (p = .153). Longitudinal analyses over the 10-year period showed no significant divergence, with all p values ≥ .600, likely reflecting limited statistical power.
Clinical Implications and Future Directions
The findings suggest that hallucinations and delusions are associated with an older appearing brain in early adulthood, potentially reflecting accelerated or atypical brain maturation during adolescence. However, the apparent normalisation by age 30 indicates that this brain age gap does not inevitably progress. For clinical practice, this supports the idea that early psychotic experiences may mark transient neurodevelopmental vulnerability rather than irreversible decline.
Reference
Navarro-González R et al. Increased brain-age gap in young adults with psychotic experiences. Biol Psychiatry Glob Open Sci. 2025;100643.
