Investigators at the Silvio Conte Center for the Neuroscience of Mental Disorders at Washington University School of Medicine in St. Louis are recruiting schizophrenia patients and their siblings for a study to determine whether subtle differences in brain structure can predict who is at risk for developing the illness.
In a study funded by the National Institute of Mental Health, the researchers take MRI scans of the brain and convert those images into three-dimensional models of brain geometry. Called high dimensional brain mapping (HDBM) the technique allows the scientists to detect small differences in brain anatomy that may help predict the risk of developing mental disorders.
John G. Csernansky, M.D., the Gregory B. Couch Professor of Psychiatry and Neurobiology at the School of Medicine and director of the Conte Center, compares brain-structure analysis to looking at a damaged car.
“In the past, the limitations in our ability to analyze brain images made it necessary for the car to be missing a door or an entire fender before we could spot a difference,” he explains. “We now have the ability to see scratches in the paint or hail damage, things that were undetectable before.”
Working with C. Robert Cloninger, M.D., the Wallace Renard Professor of Psychiatry and professor of genetics at the School of Medicine, Csernansky and his team are studying patients just diagnosed with schizophrenia and their siblings who are also at risk for developing the disorder. In theory, family members at risk may have the same changes in brain structure and function as their affected siblings. The researchers want to clarify which markers of brain structure and function are most closely related to risk.
By identifying brain differences that increase risk, Csernansky believes it eventually may be possible to start treatment more quickly, perhaps even before full-blown psychotic symptoms, such as hallucinations and delusions, occur.
About 1 percent of the general population suffers from schizophrenia. Even after the initial symptoms of psychosis are treated with medication and psychotherapy, patients can relapse. And with each relapse, the patient’s condition can get worse. Between 10 and 15 percent of patients have frequent relapses. Even the best possible outcome — no future relapses of psychotic symptoms — still requires patients to take antipsychotic medications for the rest of their lives.
Early diagnosis and intervention with the most effective antipsychotic medications and psychotherapies may offer the most hope for patients with schizophrenia and their families. Taking advantage of advances in recent research, the Conte Center also has initiated the First Contact Program, which offers assessments and treatment planning to people who may be experiencing early symptoms of a psychotic illness, such as unusual perceptions, inability to concentrate, sleep disturbances or chronic anxiety and irritability. Often individuals with these symptoms also may have a family history of schizophrenia or other psychotic disorders.
Participants in Conte Center research projects must be between 9 and 30 years of age. One person must have experienced psychotic symptoms, and have a sibling in the same age range willing to participate. Study subjects cannot be recent, regular users of drugs or alcohol and must be in generally good health with no past history of seizures or serious head injury. They will undergo a brief medical history and psychiatric and medical screening tests. All participants will receive clinical and cognitive evaluations and MRI scans at no cost.
For more information or to volunteer, call the Conte Center at (314) 747-2162 or toll-free at (888) 747-2162.
Washington University School of Medicine’s full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.