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

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2021 · $616,105

## Abstract

PROJECT SUMMARY
Worldwide, up to 3% of people will experience psychosis, a heterogeneous neurodevelopmental and
neurodegenerative brain disorder typically characterized by delusions, hallucinations, and functional decline.
Currently, clinicians can identify adolescents and young adults who are at clinical high risk (CHR) for developing
psychosis. However, as the mechanisms leading to development of psychosis are not fully known, we have
limited ability to predict who will develop psychosis. Safe intervention in this population requires high confidence
in predictive biomarkers that can stratify individuals into likely clinical trajectories, and match them with effective
treatments. Africa has a very limited early psychosis research effort, resulting in a substantial gap in our
knowledge about the ethnic heterogeneity of the high-risk state. Recently, a multi-site international effort, the
Psychosis-Risk Outcomes Network (ProNET), was funded by the NIH to analyze variation in a diverse set of
biomarkers to predict individual CHR clinical trajectories. However, while countries in North America, Europe
and Asia are included in this landmark effort, it includes no African country. This is relevant, as risk genes for
psychosis as well as the clinical and cultural presentation of psychosis often differ across ethnic groups. This
proposal aims to build research capacity in Kenya, using state-of-the-art multimodal methods in Kenya identical
to that applied in the ProNET study, in order to map clinical outcomes in CHR populations (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.
In Aim 2, we will collect multi-modal biomarkers over 24 months (eight timepoints) from 100 CHR participants
(aged 15-22) including brain MRI, ERP/EEG, psychopathology, cognition, genetics, and cortisol. Healthy
volunteers (N=50) will complete baseline assessment to quantify typical variation. Aim 3 will test the hypothesis
that psychosis outcomes in Kenyan CHR populations will differ from the international ProNET CHR cohort,
including a lower rate of psychosis conversion and improved functioning. MRI and ERP analyses are expected
to find orbitofrontal cortical thinning and reduced P300 (auditory P3b) amplitude with psychosis progression.
Together, this work would address key existing knowledge gaps in global CHR research and provide insights
into ethnic heterogeneity of outcomes among CHR patients. By building capacity in CHR clinical and biomarker-
based research in Kenya, we will facilitate sub-Saharan Africa joining future international research efforts.

## Key facts

- **NIH application ID:** 10299808
- **Project number:** 1R01MH127571-01
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** DANIEL MAMAH
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $616,105
- **Award type:** 1
- **Project period:** 2021-08-18 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10299808

## Citation

> US National Institutes of Health, RePORTER application 10299808, Clinical and Biomarker-Based Trajectories of Psychosis-Risk Populations in Kenya (1R01MH127571-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10299808. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*