The clinical heterogeneity of psychotic disorders constitutes one of the greatest challenges in current Psychiatry and biomedical Neuroscience. Facing traditional nosological classifications based solely on phenotypic symptomatology, the SUCEDE Research Group has consolidated a central hypothesis: the existence of distinct biotypes underlying what we generically diagnose as psychosis.
In the recent organizational session for the start of the academic year, strategic and methodological objectives were established for the 2026-2027 period, aimed at deepening neurobiological profiling, multimodal data integration, and treatment response.
1. Sample expansion and consolidation of the multicenter network
The foundation of any robust biological characterization lies in sample power. The group has reached a significant milestone by exceeding 300 recruited patients. To maintain this trend during the current academic year, several recruitment pathways and inter-institutional connections have been structured:
- Local recruitment network: Maintenance of recruitment at the Hospital Clínico Universitario de Valladolid and the Acute Inpatient Unit, alongside collaboration with local organizations such as Fundación El Puente and referrals from Hospital Río Ortega.
- Synergy with Salamanca: Cross-integration with the funded project on physical health in psychosis. This agreement allows linking neurophysiological and neuropsychological profiling (P300 tests, Talk-Listen paradigm) with the proteomic and metabolomic characterization of patients.
- Strategic alliances: Targeted collaborations with the University of Alcalá de Henares (focused on social cognition and the P300/N100 component) and Avilés Hospital.
2. Advanced neurophysiology and multimodal neuroimaging
The methodological core of the group encompasses the combination of electrophysiological markers of information processing and structural and functional magnetic resonance imaging (MRI) techniques:
- Perturbation Complexity Index (PCI): Finalization of signal reconstruction and preprocessing stages in collaboration with Barcelona groups, prior to final analysis using biomedical engineering algorithms.
- Corollary Discharge and N100: Deepening mechanisms distinguishing self-generated from external stimulation. Anatomical connectivity analyses using diffusion tensor imaging (DTI) and functional connectivity/interregional synchrony are currently being completed.
- EEG entropy modulation: Characterization of non-linear electroencephalographic signal dynamics across different biotypes. The group aims to reinforce its internal technical autonomy in the computational processing of EEG data.
- Structural and functional MRI: Expansion of fractional anisotropy (DTI) and structural volumetry analysis across the entire accumulated cohort, along with resting-state functional MRI (resting-state fMRI) studies.
3. In vivo cellular models, genomics, and clinical prediction
The work plan incorporates translational approaches seeking to connect genetic and cellular levels with clinical phenomenology and pharmacological response:
- Nasal epithelium neuronal models: In collaboration with the Avilés team, non-invasive nasal mucosa biopsies are planned to culture epithelial cells and develop in vivo neuronal models replicating the patient’s neurobiological profile.
- Genetic biobank optimization: Reorganization of the genetic sample inventory in coordination with Hospital Sant Joan de Déu in Barcelona. A non-invasive sample recapture protocol via buccal swab will be implemented for participants without a viable sample.
- Treatment response prediction: Longitudinal analysis strictly focused on homogeneous cohorts: first-episode psychosis and clozapine initiation/switch. Both the stability of neurobiological parameters and clinical outcome markers and readmission rates will be evaluated.
Translational perspectives:
The combination of quantitative electroencephalography, multimodal neuroimaging, genomics, proteomics, and cellular models positions the SUCEDE group cohort as a benchmark model for unraveling the biological architecture of psychosis. The ultimate goal for the 2026-2027 academic year is to consolidate these markers to transform the theoretical characterization of biotypes into tools of diagnostic and prognostic utility in clinical practice.