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Neuroimaging: Schizophrenia

Neuroimaging Techniques

Computed Tomography
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Functional Magnetic Resonance Imaging
Diffusion Tensor Imaging
Single Photon Emission Computed Tomography and
Positron Emission Tomography

Reference: Yildirim and Tureli (2015), Schizophrenia: A review of neuroimaging techniques and findings
Neuropathology

19th Century - functional disorder


20th Century
neuropathological basis
limbic system
basal ganglia
cerebral cortex
thalamus
brainstem
Neuropathology

Reduced axons, dendrites and synapses --> loss of brain


volume
Excessive pruning of synapses during adolescence
Neuropathology: Cerebral Ventricles

CT Scan
lateral and third ventricular enlargement
some reduction in cortical volume
Progressive or static disease - STILL UNCERTAIN
Neuropathology: Reduced Symmetry

Lobes
temporal
frontal
occipital
Originate during fetal life
disruption in brain lateralization during brain neurodevelopment
Neuropathology: Limbic System

Postmortem brain samples


decrease in size of the region
amygdala
hippocampus
parahippocampal gyrus
Agrees with observation made by MRI studies
smaller hippocampus
functionally abnormal - disturbances in glutamate transmission
disorganization of neurons
Neuropathology: Prefrontal Cortex

Postmortem brain studies


Functional deficits
Symptoms of schizophrenia mimic those found in persons
with prefrontal lobotomies or frontal lobe syndromes
Neuropathology: Thalamus

Volume shrinkage
Neuronal loss
Medial dorsal nucleus - reduced number of neurons
Total number of neurons, oligodendrocytes and
astrocytes is reduced by 30 to 45 percent
Neuropathology: Basal Ganglia and Cerebellum

2 reasons
odd movements (awkward gait, facial grimacing, and
stereotypies)
movement disorders involving the basal ganglia are the ones
most commonly associated with psychosis
Variable and inconclusive reports about cell loss or reduction of
volume of the globus pallidus and the substantia nigra
Increase in number of D2 receptors in the caudate, putamen and
the nucleus accumbens
Serotonergic system in the basal ganglia
STUDIES INVOLVING NEUROIMAGING IN
SCHIZOPHRENIA
PET Scan

Photo taken from:


http://www.sciencephoto.com/media/262658/view
Reference: Alustiza et al. (2016) Meta-analysis of Functional and Neuroimaging and Cognitive Control Studies in Schizophrenia
Reference: Alustiza et al. (2016) Meta-analysis of Functional and Neuroimaging and Cognitive Control Studies in Schizophrenia
Reference: H. Fujiwara et al. (2014) Neuroimaging Studies of Social Cognition in Schizophrenia
Reference: H. Fujiwara et al. (2014) Neuroimaging Studies of Social Cognition in Schizophrenia
Reference: H. Fujiwara et al. (2014) Neuroimaging Studies of Social Cognition in Schizophrenia
Article: Brain Changes Unique To Schizophrenia Progression Revealed
Medscape (Melville, 2015)

First Study: significant distinctions in hippocampal


glutamate levels were shown among high-risk individuals
who transitioned to full psychosis, compared with those
who did not transition
Article: Brain Changes Unique To Schizophrenia Progression Revealed
Medscape (Melville, 2015)

Second Study: underscored the potential clinical benefits of neuroimaging


for schizophrenia management showing distinctive differences in the
neurobiology of patients who do and do not respond to treatment.
This study involved 21 unmedicated patients with schizophrenia who were
entered into a 6-week trial and were treated with the front-line antipsychotic
risperidone.
MRI scans during and at the end of the study showed that pretreatment
connectivity of the ventral tegmental area, thought to be critical for
antipsychotic activity, to the dorsal anterior cingulated cortex was positively
correlated with good response to the treatment, while connectivity to the
default mode network was negatively correlated with treatment success.
SUMMARY

Neuroimaging techniques have provided the scientific


community with an immense body of knowledge on the
pathophysiology of schizophrenia.
Volume of more or less all brain structures has in one or
more studies been associated with schizophrenia
Schizophrenia is diagnosed clinically.
END OF PRESENTATION
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