Trajectories of Brain Abnormalities in Early Schizophrenia

In the last 40 years, multiple subtle brain abnormalities in schizophrenia have been demonstrated by a large number of structural and functional neuroimaging studies. The nature and meaning of such brain abnormalities, their time of occurrence and whether they are static or progressive have been investigated by cross-sectional comparisons of patients with first-episode and chronic schizophrenia and by a number of within-subjects longitudinal studies. The findings of these investigations support the notion that some structural and functional brain anomalies predate the onset of schizophrenia and are also detectable to a larger extent in first-episode patients. Nonetheless, the heuristic value of neuroimaging studies aimed to investigate the pathophysiological trajectory of schizophrenia has been undermined by several potential confounders of brain structure and function such as antipsychotic medication intake and substance abuse. Moreover, other potential confounders such as normal brain aging, the clinical course of illness and the role of psychosocial determinants have been only partially taken into account when interpreting longitudinal brain changes in the early phases of schizophrenia. Thus, despite the large amount of literature on brain changes in the early stages of schizophrenia, the findings to date do not allow definite conclusions to be drawn about the pathophysiological trajectory of schizophrenia. Furthermore, these findings also do not adequately resolve the dispute between the neurodevelopmental and neurodegenerative hypotheses of brain abnormalities of the disorder.

This Research Topic will try to answer the question of which or how many trajectories of brain changes can be detected in early schizophrenia. It will welcome original studies as well as systematic reviews and meta-analyses of published studies in early schizophrenia, including:

• structural and functional brain abnormalities at the onset of schizophrenia
• longitudinal brain changes at the onset of schizophrenia or in high risk mental states
• confounders and moderators of brain changes at the onset of schizophrenia
• role of pharmacological and of non-pharmacological interventions in moderating trajectories of brain abnormalities in early schizophrenia.