Functional brain imaging and aging in schizophrenia

Patients with schizophrenia, even early in the course of illness, show some similarities in their brain-imaging findings to those in older normal controls; for example, ventricular enlargement and diminished functional activity in the frontal cortex. These findings suggest a possible similarity between the normal aging process and schizophrenia, or the possible existence in some schizophrenic patients of progressive processes that prematurely affect the brain in ways analogous to normal aging. In contrast to other brain regions, the basal ganglia in schizophrenia may show an atypical pattern of volumetric and metabolic change over time, possibly because of the effects of neuroleptic treatment. However, age and illness duration are highly correlated in our samples. Interpretation of imaging results is limited by the lack of studies in an adequate number of either first-break or older schizophrenic patients and the dearth of studies with longitudinal designs.