Mexican neuroscientist's journey from exile to schizophrenia research breakthroughs

In a revealing Genomic Press Interview published today in Brain Medicine, Dr. Camilo de la Fuente-Sandoval shares how personal history and scientific passion converged to create groundbreaking advances in schizophrenia treatment prediction. The distinguished neuroscientist, recently honored with the Schizophrenia International Research Society's prestigious 2024 Global Schizophrenia Award, has established a unique research paradigm that combines cutting-edge neuroimaging with comprehensive clinical care in one of Latin America's most populous urban centers.

From political exile to scientific excellence

The journey that led Dr. de la Fuente-Sandoval to become a leading voice in psychosis research began with displacement. His father, a researcher forced to flee Chile for political reasons, saw his scientific career abruptly terminated. This family history of interrupted scientific pursuit became a driving force that would later shape the younger de la Fuente-Sandoval's determination to build something lasting in neuroscience research.

During his psychiatry residency at the Instituto Nacional de Neurología y Neurocirugía, patients experiencing psychosis captivated his attention. Guided by fellow resident Ariel Graff-Guerrero, who had completed advanced neuroscience training, Dr. de la Fuente-Sandoval embarked on spectroscopy studies that would fundamentally alter understanding of early psychosis mechanisms. These initial investigations in both clinical high-risk subjects and first-episode psychosis patients revealed neurochemical alterations that had previously remained hidden from clinical observation.

The success of these early studies prompted institutional leadership to offer him laboratory space, catalyzing the creation of what would become the Laboratory of Experimental Psychiatry. This opportunity sparked an ambitious vision: developing imaging markers that could guide treatment selection rather than relying on the traditional trial-and-error approach that often delays effective intervention in young people experiencing their first psychotic episodes.

Revolutionary care model in resource-limited settings

Operating within Mexico City's sprawling metropolitan area of 22 million residents, where mental health resources remain severely limited, Dr. de la Fuente-Sandoval has engineered an innovative clinical research ecosystem. His team established a specialized outpatient clinic staffed by laboratory-affiliated psychiatrists while simultaneously implementing comprehensive evaluation protocols in the emergency department.

This integrated approach ensures that first-episode psychosis patients receive immediate, thorough assessment including routine laboratory tests, head CT scans, and selective lumbar punctures based on clinical judgment. Remarkably, approximately 8% of patients presenting with first-episode psychosis are discovered to have secondary causes such as viral encephalitis or autoimmune conditions. Could this systematic screening approach, if implemented more broadly, prevent misdiagnosis and inappropriate treatment in similar patient populations worldwide?

All patients undergo comprehensive evaluation within 24 hours of emergency admission, including neuropsychological testing and MRI studies. This rapid assessment protocol serves dual purposes: enabling immediate treatment initiation while generating crucial research data. The entire process occurs at no cost to patients, addressing both scientific questions and healthcare access barriers simultaneously.

Glutamate: The missing piece in treatment prediction

The laboratory's most significant contribution centers on discoveries about glutamate dysfunction in early psychosis. Through sophisticated MRI spectroscopy techniques applied to antipsychotic-naïve patients, Dr. de la Fuente-Sandoval's team identified elevated glutamate levels specifically within the associative striatum. More importantly, they demonstrated that these elevations normalize following effective antipsychotic treatment.

This finding opens unprecedented possibilities for treatment personalization. Rather than subjecting patients to potentially ineffective medications for weeks or months, clinicians might soon predict treatment response through baseline neuroimaging assessments. What implications might this hold for reducing the duration of untreated psychosis, a factor strongly associated with long-term outcomes? The potential to match patients with optimal treatments from the outset represents a paradigm shift in psychiatric care delivery.

The research extends beyond glutamate to encompass electrophysiology, cognitive assessment, and inflammation markers. This multidimensional approach recognizes psychosis as a complex phenomenon requiring equally sophisticated investigative strategies. By integrating multiple biological markers, the laboratory works toward comprehensive predictive models that could transform clinical decision-making.

Building global collaborations from the global South

Despite geographic and resource constraints, Dr. de la Fuente-Sandoval has positioned his laboratory at the forefront of international schizophrenia research. His leadership role in the ENIGMA Clinical High Risk for Psychosis Working Group facilitates data sharing and collaborative analyses across continents. This participation ensures that findings from Latin American populations contribute to global understanding of psychosis mechanisms.

The laboratory's success challenges assumptions about where cutting-edge neuroscience can flourish. By leveraging Mexico City's large patient population and combining it with rigorous scientific methodology, the team generates insights unavailable in better-resourced but smaller research settings. How might other investigators in resource-limited environments replicate this model of turning apparent disadvantages into scientific opportunities?

Dr. de la Fuente-Sandoval's Genomic Press interview is part of a larger series called Innovators & Ideas that highlights the people behind today's most influential scientific breakthroughs. Each interview in the series offers a blend of cutting-edge research and personal reflections, providing readers with a comprehensive view of the scientists shaping the future. By combining a focus on professional achievements with personal insights, this interview style invites a richer narrative that both engages and educates readers. This format provides an ideal starting point for profiles that explore the scientist's impact on the field, while also touching on broader human themes. More information on the research leaders and rising stars featured in our Innovators & Ideas -- Genomic Press Interview series can be found in our publications website: https://genomicpress.kglmeridian.com/.