Brain Imaging May Detect Schizophrenia in Early Stages

Schizophrenia Update, December 2002

Excerpt of article By ERICA GOODE
(New York Times, Dec. 11,2002)

"In a new study, researchers for the first time have detected similar abnormalities in brain scans of people who were considered at high risk for schizophrenia or other psychotic illnesses but who did not yet have full-blown symptoms. Those abnormalities, the study found, became even more marked once the illness was diagnosed.

The subjects in the study who went on to develop psychoses had less gray matter in brain areas involved in attention and higher mental processes like planning, emotion and memory, the researchers found.

Experts said the study's results, reported yesterday in an online version of The Lancet, the medical journal, offered the possibility that imaging techniques might eventually be used to predict who will develop schizophrenia, a devastating illness that affects more than 2.8 million Americans. Doctors could then offer treatment while the disease was still in its earliest stages, possibly preventing further damage to the brain.

But Dr. Christos Pantelis, an associate professor of psychiatry at the University of Melbourne and the lead author of the report, cautioned that much more research was needed before magnetic resonance imaging, the method used in the study, could serve as a diagnostic tool for individual people with schizophrenia."


The article went on to say that:

"Dr. Herbert Y. Meltzer, a professor of psychiatry at Vanderbilt University and an expert on schizophrenia, said, "It proves that the psychosis is almost a late stage in the evolution of the disease process."

He added, "The key message is that this is a neurodevelopmental disorder and that changes in memory, learning, attention and executive decision-making precede the experience of the psychosis."

People who suffer from schizophrenia typically experience auditory hallucinations and have blunted emotional responses and difficulty with activities that require planning or other higher-level processes.

Some studies have suggested that the earlier the illness is treated with antipsychotic drugs the better the prognosis. At least two research groups, one led by Dr. Patrick McGorry, an author of the Lancet report, and another at Yale, are conducting studies in which young people who are experiencing some symptoms but have not yet developed schizophrenia are treated with antipsychotic drugs. But the studies have been controversial because it is not yet clear which symptoms predict later illness.

In the new study, the researchers used magnetic resonance imaging to scan the brains of 75 people who were deemed "at high risk" for psychosis because they had a strong family history of severe mental illness or had other risk factors, including transient or mild symptoms of mental disturbance or a decline in mental functioning.

Over the next 12 months, 23 of the subjects developed a full-blown psychosis and 52 did not fall ill, the researchers found.

A comparison of the brain scans from the two groups revealed significant differences in the volume of gray matter in areas of the frontal and temporal lobes and the cingulate gyrus. All three regions have been linked to schizophrenia by previous research, Dr. Pantelis said."



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