Brain scans may reveal early signs of schizophrenia at puberty

Changes in brain function may foreshadow schizophrenia as early as puberty -- nearly a decade before most patients begin showing obvious symptoms, new research from the University of North Carolina shows.

Researchers looked at brain scans of 42 children, some as young as 9, who had close relatives with schizophrenia. They saw that many of the children already had areas of the brain that were "hyper-activated" in response to emotional stimulation and tasks that required decision-making, said Aysenil Belger, an associate professor of psychiatry at the UNC School of Medicine and lead author of the study.

"These children are trying extra hard to do something that other children are able to do without so much effort," Belger said.

Belger said her team's findings could help establish an earlier diagnosis of the brain disease and ultimately point to techniques for offsetting or minimizing disease progression.

Among the possibilities for treatment are hormone therapies, cognitive-skills training and new medicines to improve brain function.

People who have a parent or sibling with schizophrenia are about 10 times more likely to develop the disease than those who do not. Signs of the illness typically begin in the late teens to mid-20s. These include declines in memory, intelligence and other brain functions that indicate a weakening in the brain's processing abilities. More advanced symptoms may include paranoid beliefs and hallucinations.

Belger and her research team have been involved in previous studies that identified at-risk teens beginning at age 16.

The latest study, published in the March 6 issue of the online journal Psychiatry Research: Neuroimaging, intentionally drew its subjects from a younger age group.

"We were interested in seeing if being a first-degree family member of someone with schizophrenia meant their brains were already different," Belger said.

The scientists examined brain activity using functional magnetic resonance imaging (fMRI) while the children solved problems or viewed pictures designed to trigger emotional responses.

"Puberty is a particularly important time because that's when the brain changes tremendously, both functionally and structurally," Belger said. "These changes are accompanied by cognitive and emotional changes, but they don't all happen at the same pace. The emotional area tends to develop faster than the decision-making areas. That's why teenagers are very emotional and impulsive. For most people, this imbalance is temporary -- when puberty is over, at some point, your cognition and emotions become regulated. But for some people this doesn't happen."

The researchers hope to learn more about brain development in at-risk youth by continuing to follow the subjects of their research over the next several years.

The team's research is being funded by the National Institute of Mental Health and the National Institute of Child Health and Human Development.