Can The Brain Try To Repair Itself After Schizophrenia

ANDRZEJ KRAUZE Asouthward a psychiatrist at Western University in London, Ontario, Lena Palaniyappan regularly sees patients with schizophrenia, the chronic mental disorder that drastically affects how a person thinks, feels, and behaves. The disorder can exist devastating, often involving hallucinations and delusions. Only 1 thing Palaniyappan and other mental health professionals have noticed is that, dissimilar those with degenerative neurological disorders such equally Alzheimer's disease, Huntington's, or Parkinson's, sometimes schizophrenia patients eventually start to ameliorate.

"In the clinic nosotros practise actually meet patients with schizophrenia having a very relentless progress in early on years," Palaniyappan says. "But a lot of them do get better over the years, or they don't progress equally [chop-chop]." So far, most research has focused on the neurological decline associated with schizophrenia—typically involving a loss of encephalon tissue. Palaniyappan and his colleagues wondered whether in that location might be "something happening in the brain [that] helps them come...

To get at this question, he and his colleagues performed MRI scans to appraise the cortical thickness of 98 schizophrenia patients at various stages of illness. Sure enough, the researchers noted that, while patients who were less than ii years removed from their diagnosis had significantly thinner tissue than healthy controls, those patients who'd had the disease for longer tended to show less deviation in some brain regions, suggesting some sort of cortical amelioration (Psychol Med, doi:10.1017/S0033291716000994, 2022). "Some encephalon regions are regaining or normalizing while other brain regions go on to prove deficits," Palaniyappan says.

"We know very well now that the brain is plastic and changes over time, but we didn't know if this could happen as a repairing machinery or a compensatory mechanism in schizophrenia," says Antonio Vita, a professor of psychiatry at the University of Brescia in Italy. "This is a strong suggestion that this could happen."

Palaniyappan cautioned, however, that he and his colleagues were only looking at a snapshot of schizophrenia patients and correlating cortical thickness with duration of illness. To better understand how the brain changes over fourth dimension in this disease, it will be necessary to follow private patients, taking multiple brain scans over the grade of their illness, he says. Moreover, he adds, "the improvement in brain tissue in these patients does not directly relate to getting ameliorate in terms of symptoms. . . . If it is bounty, it'southward non fully efficient."

"It'south very preliminary," agrees Georgia State Academy's Jessica Turner, who was not involved in the research. "These guys were very careful in what they did, but until you do it once again and again and again, it'southward a piddling bit tricky." And while 100 subjects used to be considered "a huge data fix," she says, with effect sizes every bit pocket-sized equally they are in schizophrenia, researchers need to look at thousands to "really get a sense what's going on."

Last year, Turner and her colleagues in the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) group organized a study across 15 centers worldwide. Participating researchers used standardized methods to appraise the subcortical brain structures of a total of ii,028 schizophrenia patients and two,540 good for you controls (Mol Psychiatry, 21:547-53, 2022). And before this year at the annual meeting of the Club of Biological Psychiatry, Turner's team presented results they're at present writing upward on the cortical thickness and surface area of schizophrenia patients, using data from more than xxx centers in Australia, Korea, Japan, South Africa, Europe, and the U.S. "The goal is replicability," says Turner. "Can we find consistent results that are non dependent on a particular data set or a particular subset of subjects?"

And for the about part, the answer is yes. Although the effect sizes from individual study sites are small—so pocket-size that most groups working independently probably would not have published their results, Turner says—collectively, the data tell a consequent story. "Almost all of them agree that almost all the encephalon regions are thinner in the cases than in the controls," she says. But when the ENIGMA grouping looked for bear witness that schizophrenia patients regain brain mass as their disease goes on, they didn't find it, though the data practice suggest that some areas of the brain begin to thin at a slower rate.

Palaniyappan is broken-hearted to understand if the reparatory upshot he and his colleagues observed is replicable, and if so, to study what factors might be contributing. All of Palaniyappan's study subjects were on antipsychotics at the time of their MRI scans, he notes, and so whether the same changes would have been seen without treatment remains unclear. "But we never used to think that the schizophrenic brain can recover," he says. "[Our report] is an indication the brain is making some attempts, with help or without help."

Source: https://www.the-scientist.com/notebook/do-schizophrenic-brains-repair-themselves-33099

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