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The brain in schizophrenia
1Clinical Brain Disorders Branch, National Institute of Mental Health, Neuroscience Center at St. Elizabeth's Hospital, Washington, D.C. 20032.
Seminars in Neurology
|September 1, 1990
Summary
Schizophrenia research consistently shows enlarged cerebral ventricles, indicating a central nervous system lesion. Further studies are needed to pinpoint the exact brain region and understand the developmental origins of this complex disorder.
Area of Science:
- Neuroscience
- Psychiatry
- Neuropathology
Background:
- Schizophrenia research has yielded consistent findings of enlarged cerebral ventricles.
- This ventricular enlargement is independent of treatment and disease duration, suggesting a structural brain abnormality.
- Previous research has implicated temporal lobe-hippocampal alterations and frontal lobe dysfunction.
Purpose of the Study:
- To review the current understanding of the neuropathologic and neurochemical underpinnings of schizophrenia.
- To highlight the significance of ventricular enlargement as a key neuropathologic finding.
- To explore emerging hypotheses regarding early brain development abnormalities in schizophrenia.
Main Methods:
- Review of neuropsychologic, neuroradiologic, neuropathologic, and neurochemical studies.
- Application of advanced neuroimaging techniques like CT, MRI, rCBF, and PET.
- Analysis of in vivo and postmortem anatomic data.
Main Results:
- Consistent evidence of mild cerebral ventricular enlargement in schizophrenia patients.
- Identification of pathologic alterations in the anteromedial temporal lobe, particularly the hippocampus.
- Suggestive evidence of frontal lobe dysfunction, though neuropathologic basis is unclear.
Conclusions:
- Cerebral ventricular enlargement is the most reproducible neuropathologic finding in schizophrenia, indicating a structural CNS lesion.
- The precise localization and etiology of temporal lobe-hippocampal pathology require further investigation.
- Schizophrenia may stem from early brain developmental abnormalities, potentially interacting with later neural system maturation.