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Functional Brain Abnormalities in Youth at Clinical High Risk for Psychosis

Daniel Mathalon, PhD, MD
Professor, Department of Psychiatry University of California, San Francisco

Are brain abnormalities related to schizophrenia? Dr. Daniel Mathalon starts by talking about the schizophrenia prodome as the phase when individuals are exhibiting signs of schizophrenia, but highlighting that only a subset of those individuals will develop a full blown disorder. He explains the different syndromes that make someone qualify as prodromal, such as attenuated positive symptom state, brief intermittent psychotic state, and genetic risk and deterioration state. He then goes into an explanation of event-related potentials (ERP), which are used to identify the brain abnormalities in individuals with schizophrenia. Dr. Mathalon suggests several causes of schizophrenia. He states it can be caused by excessive synaptic pruning in the prefrontal cortex and by gray matter decline (since individuals with schizophrenia have higher cortisol levels and the cortisol levels are related to gray matter decline). In addition, he looks at the role of neural inflammation because individuals with schizophrenia showed increased inflammation in certain brain areas. Furthermore, he states that the inflammation is linked to gray matter decline. Then, he suggests how synaptic plasticity has been implicated as a risk factor for schizophrenia. Finally, Dr. Daniel Mathalon acknowledges that there are several neurophysiological causes that signal risk of developing schizophrenia, and proposes a hypothesis for an experiment that could clarify the relation between gray matter decline, excessive synaptic pruning and synaptic plasticity.


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