Brain response to emotional interference in young twin pairs discordant for psychotic risk.

BACKGROUND: Neuroimaging studies have shown altered emotional interference brain activity across the psychosis spectrum, but the relative contributions of genetic and environmental factors remain unclear. This study investigates Emotional Interference (EI) performance and brain activation in twins at risk of psychosis (RT), their not at-risk co-twins (NRT), and healthy controls (HC). METHODS: 13 twin pairs (8 dizygotic and 5 monozygotic; mean age 17.6 ± 5.1) from the Italian Twin Registry, discordant for psychotic risk, and 13 age- and sex-matched HC completed an emotional Continuous Performance Task (eCPT) during MRI. Three sets of comparisons were performed: RT vs NRT; RT vs HC; NRT vs HC. RESULTS: No eCPT performance differences emerged. RT showed greater activation than HC and NRT during neutral EI, in temporal and occipital regions, likely driven by non-shared environmental factors. Similar regions showed higher activation in RT than HC during negative EI, with NRT activation falling in between, suggesting a genetic contribution. During positive EI resolution, NRT exceeded RT in occipital-cerebellar areas, possibly reflecting environmentally shaped resilience. CONCLUSIONS: Our findings indicate that different types of EI may reveal brain activity patterns that can serve as early markers of vulnerability or resilience to psychosis, primarily affecting regions involved in basic facial perception.