Research into the origins of schizophrenia in the brain offers hope for targeted treatments and better diagnosis

A group of scientists hopes their findings on how schizophrenia originates in the brain and develops over time will pave the way for targeted treatments and better diagnosis of this serious mental illness.

In a study published in Scientific progressThe researchers said they used a new method called “epicentre mapping” to analyse brain scans of 1,124 people with schizophrenia.

This allowed the researchers to identify two brain regions where structural abnormalities in people with schizophrenia are most likely to begin: Broca’s area and the frontoinsular cortex. These regions control language and emotional processing.

The researchers also found that despite identifying these two common areas, the disease can also develop in other parts of the brain.

“This suggests that everyone with this condition has a unique starting point, which may explain the differences in symptoms,” said Dr. Lena Palaniyappan, a professor of psychiatry at McGill University and one of the study’s lead authors.

“But there is a common process that results in more diffuse, though subtle, changes in brain structure,” he added. “This insight provides an important clue to the age-old question of whether schizophrenia is one disease or many diseases.”

Connecting patients to the right treatment

Schizophrenia can present in different ways in patients, making it often unclear which treatment options are best. For example, while there are a number of treatments available to prevent worsening of problems associated with psychosis, researchers say it can be difficult to know which patients will benefit from different treatments.

“By using techniques such as epicenter mapping, we can identify which parts of the brain are most affected, even before noticeable symptoms occur. This information can then help us identify patients who are likely to do better with specific treatments,” said Jianfeng Feng, a professor at Fudan University’s Institute of Science and Technology for Brain-inspired Intelligence (ISTBI) and Computer Science at the University of Warwick, who led the consortium behind the work.

Detecting brain abnormalities can influence treatment strategies, but there is a major problem: not everyone with psychosis gets a brain scan.

“Collecting good quality MRI data as a byproduct of routine health care for mental disorders such as schizophrenia may help us overcome selection bias in neuroimaging studies, and its implementation will provide clear directions for clinical practice,” said Yuchao Jiang, a postdoctoral researcher from Fudan University who led this work with Dr. Palaniyappan.

Patients with psychosis often face unemployment and social exclusion due to speech and communication problems. The researchers say they hope their study will spur clinical trials that use epicenter mapping to better match patients with treatments, particularly those focused on language and communication.