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Neuroscience and Psychiatry |

Neurodevelopmental Trajectories, Disconnection, and Schizophrenia Risk

Matcheri S. Keshavan, MD1; Tomas Paus, MD, PhD2,3
[+] Author Affiliations
1Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
2The Rotman Research Institute, Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
3Child Mind Institute, New York, New York
JAMA Psychiatry. 2015;72(9):943-945. doi:10.1001/jamapsychiatry.2015.1119.
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This Neuroscience and Psychiatry article discusses white matter alterations and brain connectivity in schizophrenia.

In the last century, the following 2 concepts have guided our thinking about schizophrenia: schizophrenia as a neurodevelopmental disorder and disconnection syndrome. Although past examinations of developmental trajectories as premorbid antecedents have focused on gray matter, altered properties of white matter and connectivity have been gaining more attention in the pathophysiology of schizophrenia. Several studies, including a JAMA Psychiatry article,1 are beginning to illuminate the nature, timing, and clinical consequences of alterations in such developmental trajectories. Thus, the 2 concepts are coming together.

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Figure.
The Extent and Timing of Development Across Several Brain Regions

The age by which the region reached 90% of its development plateau from 5 years is shown in the colored bar and specific colors of bars represent the percentage increase of fractional anisotropy from 5 to 30 years. The fornix, centrum semiovale, and corona radiata showed no changes of fractional anisotropy (data not shown). Frontotemporal connections (eg, the cingulum and uncinate fasciculus) tend to mature later than other structures. Deep gray matter underwent large percentage changes, with the subcortical white matter showing moderate changes and white matter tracts showing smaller but significant changes. Error bars indicate standard errors. IFO indicates inferior fronto-occipital fasciculus; ILF, inferior longitudinal fasciculus; SFO, superior fronto-occipital fasciculus; and SLF, superior longitudinal fasciculus. The figure is adapted with permission from the Lebel et al study.10

aIncreases of fractional anisotropy for the uncinate fasciculus extend beyond 30 years of age.

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