Recent Advances and Future Directions in Brain MR Imaging Studies in Schizophrenia: Toward Elucidating Brain Pathology and Developing Clinical Tools

Magn Reson Med Sci. 2022 Oct 1;21(4):539-552. doi: 10.2463/mrms.rev.2021-0050. Epub 2021 Aug 19.

Abstract

Schizophrenia is a common severe psychiatric disorder that affects approximately 1% of general population through the life course. Historically, in Kraepelin's time, schizophrenia was a disease unit conceptualized as dementia praecox; however, since then, the disease concept has changed. Recent MRI studies had shown that the neuropathology of the brain in this disorder was characterized by mild progression before and after the onset of the disease, and that the brain alterations were relatively smaller than assumed. Although genetic factors contribute to the brain alterations in schizophrenia, which are thought to be trait differences, other changes include factors that are common in psychiatric diseases. Furthermore, it has been shown that the brain differences specific to schizophrenia were relatively small compared to other changes, such as those caused by brain development, aging, and gender. In addition, compared to the disease and participant factors, machine and imaging protocol differences could affect MRI signals, which should be addressed in multi-site studies. Recent advances in MRI modalities, such as multi-shell diffusion-weighted imaging, magnetic resonance spectroscopy, and multimodal brain imaging analysis, may be candidates to sharpen the characterization of schizophrenia-specific factors and provide new insights. The Brain/MINDS Beyond Human Brain MRI (BMB-HBM) project has been launched considering the differences and noises irrespective of the disease pathologies and includes the future perspectives of MRI studies for various psychiatric and neurological disorders. The sites use restricted MRI machines and harmonized multi-modal protocols, standardized image preprocessing, and traveling subject harmonization. Data sharing to the public will be planned in FY 2024. In the future, we believe that combining a high-quality human MRI dataset with genetic data, randomized controlled trials, and MRI for non-human primates and animal models will enable us to understand schizophrenia, elucidate its neural bases and therapeutic targets, and provide tools for clinical application at bedside.

Keywords: Brain/MINDS beyond human brain MRI project; brain development; multi-modal brain image; psychiatry; traveling subject.

MeSH terms

  • Brain / diagnostic imaging
  • Brain / pathology
  • Diffusion Magnetic Resonance Imaging
  • Humans
  • Magnetic Resonance Imaging / methods
  • Schizophrenia* / diagnostic imaging
  • Schizophrenia* / pathology

Grants and funding

This study was supported by the Japan Society for the Promotion of Science (JSPS)/MEXT KAKENHI (18K07604, 19H03579, 20KK0193, and 21H02851), the Japan Agency for Medical Research and Development (AMED; JP20dm0307004 and JP20dm0207069), and Japan Science and Technology Agency (JST) Moonshot R&D Grant Number JPMJMS2021. This study was also supported by UTokyo Center for Integrative Science of Human Behavior (CiSHuB) and the World Premier International-International Research Center for Neurointelligence (WPI-IRCN).