Infant brain scan for schizophrenia

In a rush this morning, so I don't have time to find the links, but I've talked several times about being able in the future to scan newborns' brains and find signs of mental illness, so that early intervention means the first day. Well it's here. They found characteristic signs of schizophrenia in the brains of babies a few weeks old.

So the problems I talked about are here now.

• How do you treat a kid you know to be at high risk of some mental illness. One presumes medication will be involved, but do you treat the kid differently? For schizophrenia, probably not. For autism, maybe. Maybe knowing at birth that a kid has, say, 90% chance of becoming autistic, do you arrange the kid's room or experiences in a way not to trigger it? I don't know. How about a kid with the gene for uncontrollable aggression? Do you treat them the same way you treat another kid who smacks a playmate? I don't know, but we should be thinking about it.
• Not every kid with these characteristic brain signs will develop schizophrenia, or probably whatever is being tested for. If there is a 90% chance of some bad thing, do you risk screwing up the 10% who don't have it by treating them as though they do? I don't know.

Toward a cause of schizophrenia

I'd heard that kids of women who had the 1918 Spanish flu in the second trimester had an elevated incidence of schizophrenia. Now researchers have found that Rhesus monkeys born to mothers who had mild flu early in the third trimester had brain scans that look like humans with schizophrenia. Something during pregnancy does it.

Toward an explanation for schizophrenia's timing

Researchers looked at patterns of gene expression in the brains of schizophrenic patients. Mostly they are they same as normal people, but:

the most surprising finding was a significant link between aging and gene expression patterns in schizophrenia. The team identified several groups of co-expressed genes that behaved differently in schizophrenia patients compared to normal subjects when age was considered.

A particularly striking age-related difference in co-expression was found in a group of 30 genes related to developmental processes of the nervous system. Normally these genes are turned off as a person ages, but in schizophrenia patients the genes remain active. This critical finding strongly suggests that age-related aberrant regulation of genes important for development can explain at least part of the manifestation of schizophrenia.

We're getting closer to figuring it out. And then we'll have to figure out how to turn those genes off when they should turn off.

Preventing schizophrenia

A scenario I worried about last weekend has come not to pass but to discussion, but their plan for doing it is better than the one I worried about.

If people work the same way as rats, the brains of people who become adult schizophrenics start diverging from normal during rat adolescence, but giving them a particular set of drugs at the appropriate time can arrest the brain changes.

These researchers propose, after further study, to image the brains of kids at genetic risk of becoming schizophrenic at appropriate intervals, and put those kids who show signs of brain changes on meds to stop the changes.

This sounds like a good plan to me. Use genetics to determine whom to test, and then medicate only the ones who actually show physical signs of the problem.

Now we need to develop similar plans for kids who are at risk of other fixable problems.

Predicting schizophrenia

One neat thing about science is that when somebody does a study and publishes the data, other people can parse the data in different ways and find out stuff the original researchers weren't thinking of. Some researchers from Duke have looked at a long-term study of 1000 people born in New Zealand in 1972 and 1973 and found that the 1%  to 3.5% of people who developed schizophrenia as adults showed a consistent pattern of cognitive difficulties starting at about age 7.

For each year between the ages of 7 and 13, the children who later received a diagnosis of schizophrenia lost between 0.17 and 0.26 years in mental age when compared with the other children.

Two patterns emerged: The children who developed adult schizophrenia had early deficits in verbal and visual learning, reasoning and conceptualization that remained with them as they grew. They also showed slower development than their peers in processing speed, attention, visual-spatial problem-solving and working memory. The data argues against one theory that schizophrenia stems from a deterioration of cognitive abilities. The minds of these children grew, they just didn't grow as well.

 We're back to the question of what do you do with a kid if you know she has a good chance of developing some mental problem later?

One complication here is that something like 20% of kids had similar cognitive problems but did not become schizophrenic. So suppose a 7 or 8 year old shows the problems. If all this is true, you know she has about a 5% chance of becoming schizophrenic. Or let's make it harder. You have a class of 20 kids with cognitive problems. Odds are one of them will turn out to have been in an early stage of schizophrenia.

What do you do? Nothing directly. You certainly couldn't give anti-psychotic drugs to all 20. I haven't particularly looked into it, but I'm not aware of any cognitive therapies for schizophrenia, and in any case you wouldn't want to do that to the other 19 kids, either. I guess all you can do is watch for clearer signs and then start the meds. Sometimes knowing just a little too much is depressing.