Clinical and Biomarker-Based Trajectories of Psychosis-Risk Populations in Kenya

ABSTRACT The parent study, “Clinical and Biomarker-Based Trajectories of Psychosis-Risk Populations in Kenya”, aims to build research capacity in Kenya, using state-of-the-art multimodal methods in order to map clinical outcomes in adolescents and young adults at clinical high risk (CHR) for developing schizophrenia (Aim 1). This involves

building ERP/EEG infrastructure in Nairobi, by acquiring research grade acquisition equipment and software; MRI upgrades, including advanced diffusion and fMRI BOLD imaging capability; and elaborate research training. The study also collects multi-modal clinical and biomarkers over 24 months from 100 CHR participants including

brain MRI, ERP/EEG, genetics, and cortisol, as well as baseline data from 50 healthy volunteers (Aim 2). Finally, the study would test the hypothesis that psychosis outcomes in Kenyan CHR populations will differ from the international CHR cohort by having fewer psychosis conversions and improved functioning (Aim 3).

Our goal in this supplement request is to harmonize the research protocol and assessments with that of the 42 international sites within the ProNET and PRESCIENT networks, funded through the Accelerated Medicine Partnership – Schizophrenia (AMP-SCZ) consortium. Components of this supplement will allow for: 1) increasing

the number of longitudinal timepoints to fifteen, 2) including healthy controls in longitudinal assessments, 3) including passive and active digital biomarker assessment, 4) incorporating AMP-SCZ assessment training and increased supervision, and 5) developing an ERP/EEG laboratory to enable high-quality data acquisition. The

study methods (with the exception of blood collection), protocol and recruitment criteria will mirror that of other AMP-SCZ consortium sites, and data obtained will be publicly shared. This supplement is important as there are no AMP-SCZ consortium sites within the continent of Africa. Our publicly-shared results will facilitate cross-cultural investigations of CHR data, which is relevant considering the

rates of psychosis reported in those with African ancestry and ethnic heterogeneity of psychosis risk genes.