Imaging Approaches in Schizophrenia: A Detailed Analysis Report

This report delves into the application of various imaging techniques, primarily Magnetic Resonance Imaging (MRI) and functional neuroimaging, in the study of schizophrenia. It explores how these methods have enabled researchers to identify structural changes in the brains of affected individuals, including reduced gray matter volume in the frontal and temporal lobes, ventricular enlargement, and alterations in the temporal lobe. The report also discusses the cognitive impairments associated with schizophrenia, such as difficulties with working memory, attention, and executive functions, and how imaging helps to understand the neural mechanisms underlying these symptoms. Furthermore, it examines the role of neuroimaging in detecting the disease, localizing brain processes, and understanding the impact of the disease on the brain. The report highlights the importance of these imaging approaches in diagnosing schizophrenia and in understanding the underlying neurobiological mechanisms of the disease, thus contributing to the development of effective treatments. The report emphasizes the fact that schizophrenia is a brain disorder and involves structural changes in the brain.

Running head: IMAGING APPROACHES TO THE STUDY OF SCHIZOPHRENIA
IMAGING APPROACHES TO THE STUDY OF SCHIZOPHRENIA
Name of the Student
Name of the University
Author Note

1IMAGING APPROACHES TO THE STUDY OF SCHIZOPHRENIA
Abstract:
Schizophrenia is identified as a severe chronic disease affecting psychotic behaviour of the
patient. The characteristic symptoms includes auditory and visual hallucinations, dizziness,
bizarre, depression and delusions. Neuroimaging studies has enabled the detection of
schizophrenia and determined the structural changes in the brain of the affected individual. The
exact cause of schizophrenia is not revealed anywhere, however, there are certain risk factors
like individuals affected by influenza virus in the prenatal period have a high probability of
developing this disease. Other factors may include genetic or family history, neurochemical
irregularities and prenatal exposure to malnutrition contribute to the chance of occurrence of this
disease. The paper is an illustration of approaches towards the study of schizophrenia and the
localisation of brain process through imaging observed in the patients affected with
schizophrenia.

2IMAGING APPROACHES TO THE STUDY OF SCHIZOPHRENIA
Introduction:
Schizophrenia is a psychiatric disorder that is chronic and serious affecting people
worldwide. The main symptoms of schizophrenia includes psychotic outbreaks, negative
psychotic behaviors, bizarre, depression, auditory and visual hallucinations and many more. The
traditional treatment against this disease includes arrange of antipsychotic drugs that targets
dopamine and serotonin pathways in the brain of the affected individual. The drugs are atypical
neuroleptics that aims at providing increased therapeutic efficacy and offers fewer side effects.
Although, there are lesser known facts about the occurrence of schizophrenia, it is mainly caused
due to genetic reasons and the risk factors are identified as fetal malnutrition, hypoxia, extremely
premature and ischemia. People born in the winter months and those subjected to influenza virus
in the second quarter trimester have an increased risk of schizophrenia. Schizophrenia is mainly
characterized by impaired cognitive process and disruption in brain development. Individuals
suffering from this disease is diagnosed using Magnetic Resonance Imaging (MRI) brain
imaging and other visualization (Pasternak et al., 2015). Positive, negative and cognitive
symptoms are characteristic of it. Positive symptoms is occurred during psychotic exacerbations
and negative and cognitive symptoms emerges before the first psychotic symptoms and persist
with the course of schizophrenia (Chung & Cannon, 2015). While positive symptoms happen
regularly during psychotic exacerbations, adverse and cognitive symptoms often appear before
the first psychotic episode and continue with low functional results and bad prognosis.

3IMAGING APPROACHES TO THE STUDY OF SCHIZOPHRENIA
Discussion:
What is Schizophrenia?
Schizophrenia is a serious mental disorder with psychotic symptoms such as
hallucinations, loss of cognitive and initiative behavior and delusions. Schizophrenia patients
have an abnormal anatomical neural connectivity in the brain (Heuvel & Fornito, 2014).
Schizophrenia is related to a disruption in the brain’s thought process that affects the patient’s
overall ability to think and react. People suffering from schizophrenia have hallucinations and
they believe in things that are not real. The main mechanism of proper functioning of human
brain is characterized by the coordination of multiple spatially distributed regions of brain and
disruption occurs when these brain regions have damage in their interconnecting axonal
pathways ((Damaraju et al., 2014). The emotional intelligence of the affected individual is lost
and dysfunction of interneurons is noticed. Schizophrenia can be understood as a neuro-
developmental disorder with pre-symptomatic risk, acute psychosis, pre-psychotic prodrome and
chronic illness.
How is Schizophrenia detected?
Schizophrenia is detected using brain imaging through various approaches one of them is
Magnetic Resonance Imaging (MRI) which Provides data on the brain's parenchyma of gray and
white matter and also on the spaces filled with cerebrospinal fluid (CSF). Individuals affected
with schizophrenia have been diagnosed to have a reduced volume of gray matter especially in
the frontal and temporal lobes (Chung & Cannon, 2015). Patients who are suffering with this
disease from a prolonged period of time have been seen to have worst symptoms including
bizarre, hearing voices, hallucinations, seeing things which are not real, delusions, negative

4IMAGING APPROACHES TO THE STUDY OF SCHIZOPHRENIA
psychotic thoughts and depression. Results found through Structural MRI used for brain imaging
of the affected patient has proven the disease to be a brain disorder affecting the structures of the
brain resulting into an structural alteration of the brain of the affected individual with a
combination of disturbances or dis balance of neurotransmission. Different parts of the brain are
affected including intracranial contents with ventricular enlargements. The temporal lobe of the
brain parenchymal region is also affected and a decrease of high percentage of volume of the
whole temporal lobe has been reported. There is also decrease in the superior temporal gyrus that
has found from the MRI study of the affected brain in one or more of its constituents,
hippocampus, amygdala, and parahippocampal gyrus, the medial temporal lobe decreases
(Pasternak et al., 2015).
Schizophrenia is also detected using functional neuroimaging that helps to identify the
neural mechanisms underlying the symptoms of schizophrenia. The connections thought as
circuits involved in schizophrenia are complicated and involves receptors and neurotransmitters
at the cortical and subcortical levels. Neuroimaging studies in schizophrenia have found to be
focused on localized brain activity and analyzing the fact whether antipsychotic medication is
able to neutralize aberrant brain activity or not (Chung & Cannon, 2015).
Localizations of brain process by imaging:
A study diagnosis of patients with schizophrenia with resonance imaging based
diagnosis. Current theories have suggested the structural neuroimaging changes that have
aroused from early adolescence due to either genetic or environmental events associated with the
individual. The neuro images obtained during the first episode of schizophrenia or in the pre
mature stage shows cortical tissue loss in the brain with enlargement of lateral ventricular and
third ventricle (Chung & Cannon, 2015). The region of brain mostly affected are noticed with

5IMAGING APPROACHES TO THE STUDY OF SCHIZOPHRENIA
smaller thalamus, enlarged caudate nucleus, reversed cerebral asymmetries and smaller temporal
lobes. Other evidences obtained through studies have shown a deterioration of brain structure
with loss of cortical tissue and progressive ventricular enlargement (Ribolsi et al., 2014). These
mechanisms have also led to impairment of initial neurodevelopmental cortical that confers
susceptibility to the emergence of neuro-degenerative processes (Ahmed et al., 2015). Among
the various questions that have raised in this context, one of the important factor is the
involvement of specific brain regions in the schizophrenia or whether the brain is involved as a
whole. Many arguments and studies were held in the view to either support or oppose the fact.
An argument raised on schizophrenia was whether it is a disorder of neural dysconnectivity. It
was even argued that the neuro images generated reflect disconnection between neural
connections. It can be noted that the post mortem disturbances noticed in cortical synaptic
formation and mitochondrial abnormalities that may involve cell membrane development are
consistent with schizophrenia (Okada et al., 2016).
Brain imaging with MRI:
MRI has proven to be successful in this area and has capacity for creating high resolution
and sequential imaging. It is an important method in determining the relative effect of
neurodevelopmental versus neuro-degenerative process in schizophrenia. The brain changes
noticed are subtle, however, several studies have shown the existence of neurodevelopmental
abnormalities on MRI scan which includes hypoplasias/heterotopias, corpus callosal agenesis
and cavum septum pellucidum that has brought etiopathologic significance (Ribolsi et al., 2014).
Schizophrenia is a chronic mental illness that causes structural changes in the gray and
white matter in the brain and these changes begins with the clinical symptoms in the cortical
regions with language processing. With its persistency, progressive ventricular enlargement is

6IMAGING APPROACHES TO THE STUDY OF SCHIZOPHRENIA
detected. MRI provides detectable change in cortical atrophy and anomalous language
processing that may predict the probability of a patient to develop schizophrenia (Chung &
Cannon, 2015).
MRI is capable of studying gray-white matter modifications in the brain of patients with
schizophrenia, temporal lobe volume decrease and superior temporal gyrus, frontal and temporal
lobe white matter relations (Ahmed et al., 2015).
Behavioral and cognitive development in Schizophrenia:
Cognitive impairment is a characteristic feature of schizophrenia. The affected individual
loses his ability to think, attention, verbal learning, working memory, executive functions and
ability to work efficiently. There are the symptoms involved in the disease noticed in the onset of
psychosis and are consistent throughout the course of the disease (Gold et al., 2014).
General Intelligence- Patients affected with schizophrenia have a lower Intelligence Quotient
(IQ) and poorer performance on non-verbal reasoning compared to the general population. They
cannot think and react effectively like normal individuals. They lack the ability to think
emotionally and logically. Evidences have proven schizophrenia patients to not only have
impaired general intelligence but also have shown impairment in specific neuropsychological
domains.
Attention- working memory impairment particularly verbal memory dysfunction is a cognitive
symptom in a schizophrenia patient. Working memory can be summarized as the ability to
maintain, manipulate and control informative stimuli. A schizophrenia patient lacks the ability to
perform these functions. Spatial working memory is a concept commonly found in schizophrenia
patients often called object working memory.

7IMAGING APPROACHES TO THE STUDY OF SCHIZOPHRENIA
Social and interpersonal relationships- Due to their inability to perceive themselves as well as
others, they become socially impaired. Their difficulty in encoding and arranging information
makes it critical and challenging for the schizophrenia patients to handle or organize
interpersonal and social situations (Pinkham 2014).
Verbal fluency- Schizophrenia patients have difficulty in speaking, learning or even interpreting
languages. Together with executive functioning impairment, their inability to encode and
retention of verbally presented information contributes to their impairment of cognitive
development.
Executive functioning- Executive functioning comprises of all the cognitive processes involved
in goal oriented behavior. Schizophrenia patients have trouble understanding and creating a
purpose of their action or plans (Malchow et al., 2016).
.

8IMAGING APPROACHES TO THE STUDY OF SCHIZOPHRENIA
Conclusion:
The evidences from neuroimaging study are enough strong to prove that schizophrenia to
be a brain disease and involves structural changes in the brain. There was previously a query on
whether the whole brain is affected or specific regions of brain are affected. Abnormalities,
although subtle in magnitude and variable in magnitude across research, are now recorded in
nearly every brain region; the most pronounced are worldwide deficits, lateral ventricular
expansion and front-temporal deficits. Although the findings of structural modifications and
progressive neuroimaging tissue loss are provocative, they are not yet clinically or diagnostically
relevant.

9IMAGING APPROACHES TO THE STUDY OF SCHIZOPHRENIA
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