Altered intra- and inter-network dynamics reflect symptom dimensions in childhood-onset schizophrenia.

Abstract

This scientific commentary refers to ‘Disrupted sensorimotor and social–cognitive networks underlie symptoms in childhood-onset schizophrenia’, by Berman et al. . (doi:10.1093/brain/awv306). Schizophrenia is a highly heritable, heterogeneous and complex brain disorder characterized by positive symptoms (e.g. hallucinations, delusions) and negative symptoms (e.g. impoverished speech, flattened affect). The clinical symptoms that feature in schizophrenia frequently present during adolescence. Considerable evidence supports the hypothesis that a component of the aetiology of schizophrenia is neurodevelopmental. The study of patients with rare childhood-onset schizophrenia (COS) provides a unique opportunity to explore this facet of schizophrenia, without the correlates of an extended disease course (e.g. years of medication, institutionalization) and comorbidity (e.g. major depressive disorder, substance abuse) that confound studies of adult patients. In this issue of Brain , Berman et al. provide compelling evidence that childhood-onset schizophrenia (and its composite symptoms) is associated with reduced functional coupling (that is, correlations between brain regions over time) within and between independent neural networks (Berman et al. , 2015). Schizophrenia is generally thought to be a whole-brain disorder, characterized by patterns of disconnectivity (Buckholtz and Meyer-Lindenberg, 2012). Connections between brain regions can be assessed using neuroimaging techniques such as MRI, which can reveal schizophrenia-related alterations in brain macrostructure, microstructure and haemodynamic activity. While techniques such as …