The neuropathology of schizophrenia

Abstract

This review of brain changes in schizophrenia provides the neuropathologist with a conceptual framework to understand this disease. Numerous conflicting reports describe structural, functional, neurochemical, and neuropathological alterations in brains of schizophrenic patients. A core clinical manifestation of schizophrenia is disruption of thought; a mental process that is poorly localized in the brain and influenced by multiple neural systems. Schizophrenia has variable clinical presentations, natural history, and response to medication that imply a pathologically heterogenous group of diseases. Recent studies suggest that schizophrenia may involve cortical, limbic, and subcortical structures as well as multiple neurotransmitter systems. Schizophrenia may result from a perinatal insult in a genetically predisposed individual that produces neuronal alterations that manifest during final synaptic reorganization and myelination of early adulthood.