Brain Imaging May Detect Schizophrenia in Early Stages
By ERICA GOODE New York Times December 11, 2002
Scientists have known for some time that people who suffer from schizophrenia
show abnormalities in the structure of their brains.
But in a new study, researchers for the first time have detected similar
abnormalities in brain scans of people who were considered at high risk for
schizophrenia or other psychotic illnesses but who did not yet have full-blown
symptoms. Those abnormalities, the study found, became even more marked once
the illness was diagnosed.
The subjects in the study who went on to develop psychoses had less gray
matter in brain areas involved in attention and higher mental processes like
planning, emotion and memory, the researchers found.
Experts said the study's results, reported yesterday in an online version of
The Lancet, the medical journal, offered the possibility that imaging
techniques might eventually be used to predict who will develop schizophrenia,
a devastating illness that affects more than 2.8 million Americans. Doctors
could then offer treatment while the disease was still in its earliest stages,
possibly preventing further damage to the brain.
But Dr. Christos Pantelis, an associate professor of psychiatry at the
University of Melbourne and the lead author of the report, cautioned that much
more research was needed before magnetic resonance imaging, the method used in
the study, could serve as a diagnostic tool for individual people with
schizophrenia.
"I think it's still too early to say how helpful it will be," Dr. Pantelis
said.
Still, other researchers called the study's findings exciting and said that
the areas of the brain in which the abnormalities were found would now be an
active focus for study.
"This is a terrific first step," said Dr. Paul Thompson, a professor of
neurology at the University of California at Los Angeles and an expert on
brain imaging and schizophrenia.
Dr. Herbert Y. Meltzer, a professor of psychiatry at Vanderbilt University and
an expert on schizophrenia, said, "It proves that the psychosis is almost a
late stage in the evolution of the disease process."
He added, "The key message is that this is a neurodevelopmental disorder and
that changes in memory, learning, attention and executive decision-making
precede the experience of the psychosis."
People who suffer from schizophrenia typically experience auditory
hallucinations and have blunted emotional responses and difficulty with
activities that require planning or other higher-level processes.
Some studies have suggested that the earlier the illness is treated with
antipsychotic drugs the better the prognosis. At least two research groups,
one led by Dr. Patrick McGorry, an author of the Lancet report, and another at
Yale, are conducting studies in which young people who are experiencing some
symptoms but have not yet developed schizophrenia are treated with
antipsychotic drugs. But the studies have been controversial because it is not
yet clear which symptoms predict later illness.
In the new study, the researchers used magnetic resonance imaging to scan the
brains of 75 people who were deemed "at high risk" for psychosis because they
had a strong family history of severe mental illness or had other risk
factors, including transient or mild symptoms of mental disturbance or a
decline in mental functioning.
Over the next 12 months, 23 of the subjects developed a full-blown psychosis
and 52 did not fall ill, the researchers found.
A comparison of the brain scans from the two groups revealed significant
differences in the volume of gray matter in areas of the frontal and temporal
lobes and the cingulate gyrus. All three regions have been linked to
schizophrenia by previous research, Dr. Pantelis said.
When the researchers conducted additional brain scans on some subjects who
developed psychoses, they found further reductions in gray matter not seen in
the scans taken before the illnesses were diagnosed.
Source:
http://www.nytimes.com/2002/12/11/health/11BRAI.html?tntemail0=&pagewanted=print&position=top
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