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

  • Prasanna N. de Silva
  • Please note a correction has been issued for this article.

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.


  • 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



Corresponding author
Correspondence Dr Prasanna N. de Silva, Monkwearmouth Hospital, Newcastle Road, Sunderland SE5 1NB, UK. Email:
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BJPsych Advances
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Do patterns of synaptic pruning underlie psychoses, autism and ADHD?

  • Prasanna N. de Silva
  • Please note a correction has been issued for this article.
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