Progressive changes in the development toward schizophrenia: studies in subjects at increased symptomatic risk

Area of Science:

• Neuroscience
• Psychiatry
• Neuroimaging

Background:

• The neurobiology of emerging psychotic disorders remains poorly understood.
• Studying individuals at clinical high risk for psychosis offers insights into illness development.
• Understanding the transition period is crucial for developing novel therapies.

Purpose of the Study:

• To review neuroimaging and neuropsychological studies in individuals at clinical high risk for psychosis.
• To identify potential neurobiological markers for psychosis onset.
• To explore therapeutic intervention possibilities during the transition phase.

Main Methods:

• Systematic review of neuroimaging studies (e.g., MRI).
• Review of neuropsychological assessments.
• Analysis of longitudinal data in ultrahigh-risk individuals.

Main Results:

• Few definitive markers distinguish those who develop psychosis from those who do not.
• Hippocampal and lateral ventricle abnormalities are not consistently found prior to psychosis onset.
• Frontal lobe measures (e.g., anterior cingulate cortical thickness) and prefrontal cortex-sensitive cognitive tests show promise.
• Longitudinal MRI reveals excessive neuroanatomical changes in individuals converting to psychosis, especially in medial temporal and prefrontal cortical regions.

Conclusions:

• Aberrant neuroanatomical changes occur during the transition to psychosis.
• Potential causes include genetic, endogenous, stress, or environmental factors.
• Active changes during transition offer potential for clinical intervention and amelioration.