Childhood onset schizophrenia: support for a progressive neurodevelopmental disorder

• Published in: International journal of developmental neuroscience Vol. 29; no. 3; pp. 251 - 258
• Main Authors: Rapoport, Judith L., Gogtay, Nitin
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.05.2011
• Subjects: Age of Onset; Anatomic; Brain; Brain - growth & development; Brain - pathology; Child; Childhood-onset; Cohort Studies; Developmental Disabilities - pathology; Developmental Disabilities - physiopathology; Disease Progression; Humans; Imaging; Longitudinal Studies; Magnetic Resonance Imaging; MRI; Phenotype; Progressive; Schizophrenia; Schizophrenia - pathology; Siblings; Progressive; Brain; MRI; Imaging; Childhood-onset; Schizophrenia; Anatomic
• ISSN: 0736-5748; 1873-474X; 1873-474X
• DOI: 10.1016/j.ijdevneu.2010.10.003

► Converging evidence points to progressive structural brain abnormalities in schizophrenia. ► Childhood-onset schizophrenia is a sever, treatment refractory phenotype with more salient genetic features. ► This review covers longitudinal anatomic brain development in childhood-onset schizophrenia. Structural brain abnormalities have become an established feature of schizophrenia and increasing evidence points towards the progressive nature of these abnormalities. The brain abnormalities are most profound in early onset cases, which have a severe, treatment refractory phenotype and more salient genetic features. Unique insights could thus be gained in schizophrenia pathology from studying the earliest manifestations of the illness. This paper reviews and updates the findings on anatomic brain development in patients with very early onset schizophrenia while showing preliminary data from ongoing studies. Collectively, our studies demonstrate that childhood-onset schizophrenia (COS) subjects show progressive loss of gray matter, delayed/disrupted white matter (WM) growth, and a progressive decline in cerebellar volume, some of which are shared by their healthy siblings. The developmental patterns or the ‘trajectories’ of brain development are often more striking than anatomic brain differences at any one point in time; highlighting the importance of longitudinal studies. The sibling findings of partially shared gray matter (GM) deficits which appear to normalize with age, along with other genetic analyses, provide evidence that the brain developmental ‘patterns/trajectories’ for several regions at particular ages could be useful endophenotypes (trait markers).