MRI reveals repair: Schizophrenia relief

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  • Published: Jun 1, 2016
  • Author: David Bradley
  • Channels: MRI Spectroscopy
thumbnail image: MRI reveals repair: Schizophrenia relief

Brain in reverse

Dynamic cerebral reorganization in the pathophysiology of schizophrenia: a, MRI-derived cortical thickness study. Credit: Lena Palaniyappan

A magnetic resonance imaging study (MRI with covariance analysis has shown for the first time that the brains of people with schizophrenia can reorganize and fight the illness.

An international team from Hunan Normal University, Changsha and Fudan University and the Shanghai Center for Mathematical Sciences, Shanghai, People's Republic of China, the University of Warwick, Coventry, the University of Nottingham, Nottingham, UK, Western University, and Lawson Health Research Institute, both in London, Ontario, Canada, has used MRI data on cortical thickness using surface-based morphometry to show that our brains may have the ability to reverse the effects of schizophrenia.

Plasticity

Schizophrenia is a mental disorder associated with delusions and confused thinking, often the sufferer has auditory hallucinations, such as hearing voices. Poor social engagement and a lack of emotional expression and a lack of motivation are common symptoms. Other mental health issues such as anxiety disorders, serious depression and substance abuse are common in sufferers. Symptoms usually emerge in young adulthood and are usually represent a long term problem. From the physiological, as opposed to psychological point of view, Schizophrenia is an illness usually associated with a widespread reduction in the volume of brain tissue. However, recent research has demonstrated that there is sometimes a subtle and potentially significant increase in brain tissue in certain specific regions of the brain.

Writing in the journal Psychological Medicine, Lena Palaniyappan of Western University and his colleagues explain how "A structural neuroanatomical change indicating a reduction in brain tissue is a notable feature of schizophrenia. Several pathophysiological processes such as aberrant cortical maturation, progressive tissue loss and compensatory tissue increase could contribute to the structural changes seen in schizophrenia."

The researchers have now studied 98 patients with schizophrenia and compared them to 83 patients without schizophrenia using MRI and covariance analysis to record the amount of brain tissue increase. Until now, these subtle changes had not been observed in detail because they are small and distributed in nature. "While temporo-limbic and fronto-parietal regions showed reduced thickness, the occipital cortex showed increased thickness, especially in those with a long-standing illness," the team reports.

Improving recovery

According Palaniyappan, there is an overarching feeling that curing people with a severe mental illness, such as schizophrenia is not possible. "Even the state of the art frontline treatments aim merely for a reduction rather than a reversal of the cognitive and functional deficits caused by the illness," he explains. Palaniyappan is Medical Director at the Prevention & Early Intervention Program for Psychoses (PEPP) at London Health Sciences Centre (LHSC).

This idea of reduction rather than reversal arises from the long-standing notion that schizophrenia is a degenerative illness, with the seeds of damage sown very early during the course of brain development. "Our results highlight that despite the severity of tissue damage, the brain of a patient with schizophrenia is constantly attempting to reorganize itself, possibly to rescue itself or limit the damage," explains Palaniyappan. This hypothesis is thus in sharp contrast to the received wisdom concerning the illness. The team next hopes to clarify the way in which this reorganization of brain tissue progresses through sequential scans of individual patients with early schizophrenia and study the effect of the changes as they go through treatment whether pharmacological, psychiatric or rehabilitation therapies.

"These findings are important not only because of their novelty and the rigour of the study, but because they point the way to the development of targeted treatments that potentially could better address some of the core pathology in schizophrenia," explains Jeffrey Reiss, who is Site Chief in Psychiatry at LHSC. "Brain plasticity and the development of related therapies would contribute to a new optimism in this illness." It is, after all, just a century ago that schizophrenia was described as a form of premature dementia because of its purported progressive degenerative effects.

Palaniyappan's work now opens up a new way of understanding that while schizophrenia may well be degenerative it is not necessarily irreversible. It might well be possible to exploit brain plasticity to help patient's compensate for negative changes in brain structure and so improve recovery.

Related Links

Psychol Med 2016, online: "Dynamic cerebral reorganization in the pathophysiology of schizophrenia: a MRI-derived cortical thickness study"

Article by David Bradley

The views represented in this article are solely those of the author and do not necessarily represent those of John Wiley and Sons, Ltd.

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