CONTACT: L. E. OHMAN
2130 Medical Laboratories
Iowa City IA 52242
(319) 335-6660; fax (319) 335-8034
UI study finds evidence of link between children and adults forms
IOWA CITY, Iowa -- People with schizophrenia, once thought to be the
victims of poor parenting, are now recognized as victims of an error in
brain development. A new University of Iowa study is helping provide evidence
that schizophrenia may in fact be a developmental disorder, present in
children though the symptoms don't usually manifest themselves until adulthood.
The study, conducted by Peg Nopoulos, UI assistant professor of psychiatry,
provides evidence that supports this theory and will help physicians better
understand the development of schizophrenia.
Her findings are published in the August issue of the American Journal
Schizophrenia is usually diagnosed in adults between the ages of 18
and 20, but it is occasionally evident in children under the age of 12.
The childhood-onset form of the disorder is similar to the adult-onset
form in many ways, but it is more severe. Adults and children with schizophrenia
share similar cognitive, motor and behavioral disorders, and the use of
magnetic resonance imaging (MRI) indicates there are abnormalities in certain
areas of the brain in both child and adult schizophrenics.
These findings suggest that schizophrenia may be a developmental disorder
in which brain anomalies are present at birth, but the symptoms of schizophrenia
generally aren't severe enough for diagnosis until a person reaches young
Nopoulos and her colleagues investigated this hypothesis by using MRI
to study the brains of 24 patients with childhood-onset schizophrenia.
Their examination focused on a brain region called the cavum septi pellucidi
(CSP). An enlarged CSP is associated with some forms of mental retardation,
and is found in 12 percent of adult-onset schizophrenics. The biological
significance of an enlarged CSP is that it can serve as a marker for anomalies
in brain development.
"When I see an enlarged CSP, it raises a red flag. It is an indicator
of brain maldevelopment and may be associated with a cognitive deficit,"
The CSP is a small cavity of fluid in a layer of tissue that separates
the lateral ventricles, two bodies of fluid inside the brain. Early in
embryonic development it starts out as a single layer, but splits into
two layers soon afterward. Just before birth, the two layers fuse back
into one. In some people with schizophrenia the tissue does not fully fuse,
and their CSP is larger than normal.
All patients with schizophrenia have cognitive deficits, such as problems
with learning, memory, organization and other intellectual skills, Nopoulos
said, and CSP development may be related to cognitive deficits in schizophrenics.
"Patients with schizophrenia who have an enlarged CSP are more
cognitively impaired than people with schizophrenia whose CSP is of normal
size," Nopoulos said.
Nopoulos found that the CSP was enlarged in about 12 percent of the
people with childhood-onset schizophrenia, about the same number found
in people with adult-onset schizophrenia. However, the size of the CSP
found in the childhood-onset sample was much larger indicating a more severe
anomaly. The finding suggests that childhood- and adult-onset schizophrenia
are the same disease on a continuum of severity.
"These findings help us understand the developmental process involved
in schizophrenia and confirms that the brain changes that we see are a
part of the disorder," Nopoulos said.