Magnetic Resonance in Schizophrenia

In vivo magnetic resonance imaging (MRI) of schizophrenic patients permits the direct and noninvasive study of brain biochmeistry, structure, and function. During the last decade, a number of morphological abnormalities have been found in schizophrenic brains on the basis of qualitative and quantitative assessment of MRIs. Changes in ventricular volume, cortical volume, temporal lobe structures, and subcortical regions have been reported. The search for a precise and specific location underlying the pathophysiology of schizophrenia has led to the interpretation of imaging results in the context of interrelated systems of brain function, rather than isolated focal brain abnormalities. Furthermore, an important goal of imaging studies is to describe unusual features of schizophrenic brains that represent abnormalities central to the development of the disorder, including abnormalities that may represent vulnerabilities or risk factors, as well as those that are directly related to psychopathology. Identifying brain pathology that distinguishes schizophrenics' brains has proven difficult because it involves detecting rather subtle changes against a background of extensive normal variation. Application of powerful new magnetic resonance techniques continues to increase our understanding of these subtle changes. The importance of magnetic resonance spectroscopy is derived from the information it provides regarding the chemical content of the tissue being studied. Functional MRI provides a method for the assessment of functional architecture by measuring changes in oxidation and regional blood flow in discrete regions of the brain in response to challenge paradigms. These technologies promise to facilitate both the detection of cortical anomalies as well as provide the methods necessary for the systematic exploration of cortical structure and function needed to examine brain dysfunction from a network perspective.