Do patterns of synaptic pruning underlie psychoses, autism and ADHD?

SUMMARY This review of available longitudinal structural imaging and immunological findings in first-onset schizophrenia, bipolar disorder, attention-deficit hyperactivity disorder (ADHD) and autism suggests that different patterns of synaptic pruning lead to various phenotypes. Proposals for future research strategies to try to replicate these findings are suggested, potential biomarkers to assist in diagnosis and determining the optimum duration of maintenance treatment are considered and ideas of potential immunotherapy augmentation are outlined. LEARNING OBJECTIVES • Understand the immunological basis of synaptic pruning • Comprehend the available research on longitudinal brain imaging • Be aware of future immunological therapeutic strategies in psychosis, ADHD and autism DECLARATION OF INTEREST None.