[Changes in the brain with schizophrenia: postmortem findings]

Area of Science:

• Neuroscience
• Psychiatry
• Pathology

Context:

• Schizophrenia research has a century-long history of investigating brain morphology.
• Well-documented changes include grey matter volume/density decreases and white matter lesions.
• These alterations contribute to brain disconnectivity, a core feature of schizophrenia.

Purpose:

• To synthesize current morphological knowledge of the schizophrenic brain across multiple scales.
• To highlight key macroscopic changes and emerging molecular insights.
• To provide a comprehensive overview of brain alterations in schizophrenia.

Summary:

• Significant macroscopic changes involve volume reductions in specific brain regions like the temporal lobe and prefrontal cortex.
• Reductions in hemispheric asymmetry, particularly in the planum temporale, are noted.
• Recent findings reveal alterations in neuropil, axons, dendrites, and synapses, with ongoing research into underlying mechanisms like aberrant migration and neuroplasticity.
• Metabolic studies show notable results in brain energy and lipid metabolism, alongside proteomic data.

Impact:

• This review consolidates understanding of schizophrenia's neuropathology.
• It identifies key areas for future research into disease mechanisms and potential therapeutic targets.
• Clarifies the complex interplay of structural brain changes in schizophrenia.