Led by the Department of Psychology at City, University of London, study suggests that functional brain imaging used over time could provide clues to schizophrenia development in the young adult.

By Mr Shamim Quadir (Senior Communications Officer), Published (Updated )

Study suggests that brain imaging taken across later adolescence could help track the brain areas affected in early onset schizophrenia (EOS), with these areas then becoming targets for pharmacological (drug) interventions to improve people’s symptoms.

Schizophrenia is a debilitating disorder with a typical manifestation of clinical symptoms in early adulthood between the mid to late 20s, including hallucinations (seeing things that are not there) and delusions (believing things that are not true).  It is thought to be a neurodevelopmental disorder, meaning that symptoms are caused by the brain not developing normally from childhood, rather than it being damaged later in life.

Whilst most people with schizophrenia develop symptoms in adulthood, there are rare cases of individuals with early-onset schizophrenia (EOS) starting before their 18th birthday, and which are typically associated with a worse progression of symptoms than schizophrenia which starts in adulthood.

Schizophrenia is also characterised by cognitive (thinking) impairments in executive processes such as in working memory (WM) which is the type of memory used to hold the relatively small amounts of information we need at a time to execute our cognitive tasks.

The study, led by the Department of Psychology at City, University of London, used ‘functional’ brain imaging (fMRI) to look at the brain activity of 14 people with early onset schizophrenia at an average (mean) age of 17 and then again four years later at age 21. As a comparison they also performed fMRI on 15 healthy aged-matched participants.

Changes in function of various structures in the brain were looked for between the initial and final fMRI brain scans over the four years, and whether there was a difference between the EOS participants and the healthy, aged-matched participants.  Participants also took tests of working memory, of varying difficulty during the fMRI scans to look at whether there were changes in brain activation over time and between the test and age-matched groups.

The study found that functional brain changes associated with working memory did not differ between patients with early onset schizophrenia and typically developing participants in the four-year period.  However, they did find that working memory development is associated with widespread functional reduction in activity in the frontotemporal and cingulate regions of the brain. They also found that severity of schizophrenia symptoms at baseline measurement predicted functional longitudinal changes in frontal, cingulate, and parietooccipital areas of the brain.

Lead author of the study, Dr Danai Dima, Reader at the Department of Psychology, City, University of London said:

This is the first longitudinal working memory (WM) fMRI investigation of whole-brain changes in functional brain recruitment in a developing sample of patients with early-onset schizophrenia. Prefrontal and parietooccipital activity reduction was affected by clinical presentation of symptoms. The clinical implications of studying the longitudinal correlates of working memory functional maturation in EOS are crucial in promoting the advancement of pharmacological targets that could one day alleviate the cognitive impairment in schizophrenia which currently has no known effective medication.

The study is published online in the journal, Schizophrenia Research: Cognition