Is schizophrenia a lifetime disorder of brain plasticity, growth and aging?

Chronic schizophrenia is characterized by change in the normal brain cortical structure, asymmetric reduction, and ventricular enlargement. The debate continues as to whether these anomalies occur early in development or represent an active progressive process continuing after the onset of psychosis. The case is made in the present manuscript for a continuing aberrant lifetime brain process. It is proposed that the underlying basis for the neuropathology of schizophrenia resides in the periodic activation of a defective gene or genes that determine the rate of cerebral growth. This process causes subtle cortical maldevelopment prenatally and through early childhood, is activated again during adolescent pruning of neurons, and again during the gradual aging process in the brain throughout adulthood. The case for a progressive active brain process in schizophrenia is thus presented.