A review of MRI studies of progressive brain changes in schizophrenia.

In the early twentieth century, when Kraepelin first described ‘dementia praecox’ which eventually evolved into the concept of schizophrenia, he proposed that dementia praecox was probably an unknown organic brain disease. However, in contrast to the case of Alzheimer’s disease and Huntington’s disease, subsequent pathological studies of the brain failed to establish the neuropathology of schizophrenia. As a result, it had been generally accepted that schizophrenia would be a functional psychosis with neurochemical aberrations but without organic abnormalities. In 1976, Johnstone et al first reported the computerassisted tomography (CT) finding of lateral ventricular enlargement in patients with schizophrenia. This finding has been replicated in a number of CT studies and has been recognized as representing brain structural abnormalities in schizophrenia. Magnetic resonance imaging (MRI) enables more detailed and quantitative assessments of the fine brain structures, providing considerable evidence for the view that schizophrenia is a brain disorder with structural brain abnormalities.