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Brain scan can predict risk of schizophrenia

[ Research Review 0307 : ]

By Janine Sim-Jones

Brain scans can be used to predict how well young people will recover from early psychotic episodes that occur in mental illnesses such as schizophrenia, according to University of Melbourne research.

Scientists in the University’s Melbourne Neuropsychiatry Centre (MNC) and ORYGEN Research Centre, have made the breakthrough.

The discovery has brought the first successful use of brain scanning to predict whether a patient’s initial psychotic episode is an isolated experience or the start of a lifelong illness, says research team leader Dr Stephen Wood.

The research shows that levels of a certain chemical in the brain can predict how a young person experiencing their first psychotic episode is likely to be affected over the next few years.

The Melbourne scientists compared the brain scans of 46 psychiatric patients with their health records over two years.

They demonstrated that low levels of the brain chemical n-acetyl aspartate early in the course of a mental illness indicated that a young person was likely to develop chronic schizophrenia.

About one in 100 Australians has schizophrenia, while about three to four per cent will experience a psychotic episode at some time in their life.

“Our findings have the potential to dramatically improve the early treatment of mentally ill patients,” says Dr Wood.

“It will lead to better diagnosis, prognosis and ultimately better treatment for patients experiencing their first psychotic episode.

“The current dilemma for psychiatrists is that until now there has been no way of scanning the brain to provide the patient with any sort of idea of their likely recovery.

“Generally psychiatrists consider factors such as the age and gender of the patient but must take a wait and see approach.

“Diagnosis and prognosis are often made once the disease progresses, and then, retrospectively, the psychiatrist can see that some of the early indicators were in fact the start of a chronic condition,” he says.

The Melbourne research used a technique known as MR spectroscopy – in which MRI scans are used to measure the concentration of chemicals in the brain – to measure the levels of n-acetyl aspartate in the frontal cortex, the brain region which controls higher-order thinking.

It found that all of those who went on to develop schizophrenia after their first psychotic episode had low levels of this chemical.

“This is the first time anyone has been able to combine the brain images and long‑term clinical data from the same group of patients to find a way of predicting outcomes for psychiatric patients,” Dr Wood says.

“Armed with information from brain scans, psychiatrists would be able to personally tailor medical programs for patients and implement more aggressive treatments for patients at risk of a poor outcome.”

Dr Wood says researchers hope to further their research by investigating whether using brain supportive supplements such as fish oil, folate, B vitamins and lithium, could lead to better recovery for patients.

Dr Wood led the research team which also involved Professor Christos Pantelis and Dr Dennis Velakoulis, from the Melbourne Neuropsychiatry Centre, and Professor Patrick McGorry from the ORYGEN Research Centre.

Findings of the research have been published in the international journal The Archives of General Psychiatry.

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Editor, Research Review
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