There is now compelling evidence from neuroimaging studies that schizophrenia is a brain disease. Abnormalities, albeit subtle in magnitude and variable in extent across studies, are now reported in virtually every brain region; global deficits, lateral ventricular enlargement, and frontotemporal deficits are the most pronounced. It is still unclear as to the relationship of these changes to associations with illness and clinical variables, and these brain changes have yet to directly affect clinical care. Even though the observations of structural changes and progressive tissue loss on neuroimaging are provocative, they are not yet of clinical or diagnostic relevance. ’
I have asymetrical ventricles but they are normal size. Gross abnormalities have been recorded before but not in every person who has sz. If this is more refined it’s interesting stuff if there’s slight changes in brain structure itself then we are still with the same thing…what causes it and can it be stopped.
Still. If it leads to better understanding which is the modern medical model then we are winning. Just slowly.
I’d just like to point out that this article is 17 years old. I’ve heard this stuff a zillion times since I’ve been on the forum. The potential for significant decline in some is well known. It’s not all bad news if you look for it though. Try a search for “the myth of schizophrenia as a progressive brain disease” or similar and you will find articles with a more positive outlook.
Edit: I actually decided to go back and reread the main article I was referring to in the search and I thought I would share its conclusion. It’s very telling:
Conclusions
The notion that schizophrenia is by nature a progressive deteriorating illness was central to the concept of dementia praecox as originally outlined by Kraepelin.2 When structural brain abnormalities and cognitive deficits were demonstrated in the late 1970s these were taken as confirming that the illness was indeed a dementia of the young.36
It is true that people with schizophrenia as a group show modest decreases in certain brain tissue volumes at the time of the FEP but much research suggests that these, at least in part, reflect neurodevelopmental abnormalities.119 In addition, MRI studies in the last decade have suggested a “progressive” component that can be detected after illness onset.120 However, the pathological nature of these changes remains unclear.121 There is no direct evidence for a toxic effect of psychosis on brain tissue, and emerging evidence from human and animal studies suggests that these changes are in part consequent upon antipsychotic medication.57,58 Furthermore, there is evidence that cannabis, alcohol, smoking, stress-related hypercortisolemia, and low physical activity also contribute to the changes in cortical and ventricular volumes observed over the course of schizophrenia. Together with the effects of antipsychotic medications, these factors appear to account for the majority of the so-called “progressive” brain changes. Their importance lies in the fact that at least some may be reversible.
The findings from neuropsychology consistently contradict the idea of schizophrenia as a progressive dementia. Cognitive deficits are present at a young age in some children who later develop schizophrenia together with slower cognitive development in a range of domains, which results in further divergence in cognitive ability by the time psychosis develops. However, there is no evidence that lasting cognitive decline occurs during the transition to psychosis or following its onset.
Thus, the idea that schizophrenia is a progressive brain disease is not supported by the weight of longitudinal neuroimaging and cognitive studies, and it is not consistent with what is now known about the clinical course of schizophrenia. It is important for optimum clinical care that the idea that underlying schizophrenia there exists an intrinsically malignant process be reconsidered. It has contributed to an undue pessimism among mental health professionals and their consequent alienation from sufferers and their representatives, who increasingly advocate for the “recovery model.”14,122
Furthermore, etiological and clinical research suggests that schizophrenia is not a discrete illness with a single cause or course, rather it appears to be a syndrome with multiple interacting causes, both genetic and environmental, and a heterogeneous outcome.123 Thus we can better conceive individuals diagnosed with schizophrenia as having a vulnerability to psychotic reactions to a range of biological124 and social risk factors.125 The greater the cumulative load of risk factors before onset, and also incurred subsequently, the more likely the individual is to have a poor outcome. Some individuals, especially those with developmental impairment, start their journey through illness with considerable impairment of their ability to cope with further stressors and show deterioration in their social functioning; others may start with less vulnerability but are exposed to repeated social adversities that prevent their recovery.
Rejecting the concept of schizophrenia as a progressive brain disease does not negate the serious and disabling problems that many patients with schizophrenia experience. No doubt, many patients experience a decline in many spheres of functioning. Further research is certainly required to determine whether there is an active period of developmental or degenerative changes that take place prior to the syndrome being expressed and diagnosed. However, it is important for patients, family members, clinicians, and the public more broadly to recognize that the deterioration that many patients experience over the long-term is not an inevitable part of the illness course. Sadly, many people with schizophrenia do not have access to the skilled mental health services and social supports that are needed for them to achieve recovery and a good quality of life. It is crucial to appreciate that the terrible social sequelae of schizophrenia such as homelessness, poverty, unemployment, hospitalization, and imprisonment are not the inevitable outcomes of a progressive brain disease but highlight the challenges we face in providing the needed services and supports, and in engaging ill people in models of care which they are likely to accept and appreciate.
Here is the full article:
Edit: And yes, even this article is almost 10 years old
I’ve always had the cognitive strengths and weaknesses I’ve got from as far back as I can remember. I don’t think having a SMI ,in itself, has made things worse when compared to people of the same age.
It may be a local colloquialism for head or brain. I haven’t given it any thought before today. “Run that around your noodle a few times,” is a saying I grew up with. It means to think something over.
