Browsing by Author "Leskelä, Laura"

Schizophrenia is a severe and often chronic disease, which causes substantial harm both to the individual and to the whole society by large. Schizophrenia has long been associated with widespread anatomical alterations in the brain, with the most extensive changes occurring during the first psychosis. More studies have also increasingly focused on whether any alterations are already noticeable before the psychosis. Knowing this enable to both start the treatment earlier, thereby improving the prognosis, and to develop novel, preventive treatments. The articles included in this review consist of longitudinal magnetic resonance imaging studies which compare the brain anatomy of inviduals with a high-risk of schizophrenia making the transition to psychosis or not. The review includes both genetic and clinical high-risk populations, with most of the articles included focusing on the latter. Taken together, the articles create a mostly consistent picture of the anatomical features of the brain associated with the transition to disease both before and during the psychosis. The amount of grey matter was found to be systemically lower and/or to reduce more rapidly than in normal population, especially in the prefrontal, parietal and temporal lobes, cerebellum and cingulate and insular cortexes. However, the whole brain volume was found to be increased. Also, the enlargement of the third ventricle was quite strongly associated with the transition to psychosis. Finally, the integrity and the amount of the white matter might have some connection to the transition, but the results are inconclusive. Based on the results, schizophrenia is associated with wide alterations in brain anatomy even before the first psychosis. It can be assumed that these alterations explain the symptoms of the disease, for example that the changes in the prefrontal cortex relate to the loss of cognitive ability. Better understanding the connection of brain anatomy to the symptoms and progress of schizophrenia enables more effective and earlier treatment.