Study: fMRI helps ID development of schizophrenia
In a functional MRI (fMRI) study, neurologists and psychiatrists at Columbia University in New York City have identified an area of the brain involved in the earliest stages of schizophrenia and related psychotic disorders, according to findings published Monday in the Archives of General Psychiatry.
Activity in a specific region of the hippocampus may help predict the onset of the disease, offering opportunities for earlier diagnosis and for the development of drugs for schizophrenia prevention, the authors wrote.
In the study, the researchers scanned the brains of 18 high-risk individuals with "prodromal" symptoms, and followed them for two years. Of those individuals who went on to develop first-episode psychotic disorders such as schizophrenia, 70 percent had unusually high activity in a region of the hippocampus, known as the CA1 subfield.
While previous studies have identified a more general increase in activity in the hippocampus in chronic schizophrenia, the investigators said their study showed that in the early stages of the illness, before symptoms are fully manifest, increased activity is evident only in this one subregion and can distinguish who among high-risk individuals will go on to develop these disorders.
Using a new high-resolution fMRI application, developed by senior author Scott A. Small, MD, the researchers compared 18 patients with schizophrenia to 18 healthy controls and observed abnormalities in multiple areas of the brains of the patients with schizophrenia.
Next, to learn which of those regions of the brain were targeted first in patients with first-episode psychotic disorders, the investigators imaged young people identified as at high risk for psychosis, who were then followed for two years to determine diagnostic outcome.
"By applying this imaging technology to a population of high-risk individuals, we wanted to see if we could find an area of the brain that is selectively targeted," said lead author Scott A. Schobel, MD, assistant professor of clinical psychiatry at Columbia and the New York State Psychiatric Institute. "In comparing those high-risk individuals who developed psychosis with those who did not, we found that only the CA1 subfield was abnormal in those young people who went on to develop schizophrenia. We believe that this may give us an early snapshot of disease."
"Our findings could help us improve diagnosis in the preclinical stage, which is most important because it is this stage of the disease that will be most amenable to treatment," said Small.
"We're now trying to understand why CA1 is selectively targeted. We need to ask what is the underlying cause and to find a pattern and investigate why this area is affected first. It may be that the CA1 subfield is also driving dysfunction in other brain regions in establishing the illness," said Small.
Activity in a specific region of the hippocampus may help predict the onset of the disease, offering opportunities for earlier diagnosis and for the development of drugs for schizophrenia prevention, the authors wrote.
In the study, the researchers scanned the brains of 18 high-risk individuals with "prodromal" symptoms, and followed them for two years. Of those individuals who went on to develop first-episode psychotic disorders such as schizophrenia, 70 percent had unusually high activity in a region of the hippocampus, known as the CA1 subfield.
While previous studies have identified a more general increase in activity in the hippocampus in chronic schizophrenia, the investigators said their study showed that in the early stages of the illness, before symptoms are fully manifest, increased activity is evident only in this one subregion and can distinguish who among high-risk individuals will go on to develop these disorders.
Using a new high-resolution fMRI application, developed by senior author Scott A. Small, MD, the researchers compared 18 patients with schizophrenia to 18 healthy controls and observed abnormalities in multiple areas of the brains of the patients with schizophrenia.
Next, to learn which of those regions of the brain were targeted first in patients with first-episode psychotic disorders, the investigators imaged young people identified as at high risk for psychosis, who were then followed for two years to determine diagnostic outcome.
"By applying this imaging technology to a population of high-risk individuals, we wanted to see if we could find an area of the brain that is selectively targeted," said lead author Scott A. Schobel, MD, assistant professor of clinical psychiatry at Columbia and the New York State Psychiatric Institute. "In comparing those high-risk individuals who developed psychosis with those who did not, we found that only the CA1 subfield was abnormal in those young people who went on to develop schizophrenia. We believe that this may give us an early snapshot of disease."
"Our findings could help us improve diagnosis in the preclinical stage, which is most important because it is this stage of the disease that will be most amenable to treatment," said Small.
"We're now trying to understand why CA1 is selectively targeted. We need to ask what is the underlying cause and to find a pattern and investigate why this area is affected first. It may be that the CA1 subfield is also driving dysfunction in other brain regions in establishing the illness," said Small.