Neuropathology of Schizophrenia

Neuropathological studies have provided clues as to the cellular and molecular correlates of the structural differences in schizophrenia that have been identified by brain imaging. There is strong evidence against the presence of a neurodegenerative process, with an absence of gliosis and of features of Alzheimer disease. There are a range of morphometric and cytoarchitectural findings, affecting the distribution, density, size, and phenotypic properties of various neuronal and glial populations. These are accompanied by alterations in the expression of various molecules indexing synaptic functioning. The changes are prominent in, but not restricted to, the hippocampal formation, dorso-lateral prefrontal cortex, and thalamus. The robustness of these findings varies, and their interpretation remains under debate. It is likely that the neuropathology reflects, at least partly, a difference in subtle aspects of the neural circuitry, arising from the neurodevelopmental and genetic origins of the syndrome. There are few established clinico-pathological correlations. Although not all potential confounds have been excluded as contributing to the findings, overall the neuropathology of schizophrenia has made significant advances as an integral part of the broader progress in understanding the neurobiology of the disorder. However, further advances are required before the knowledge base might become of diagnostic or clinical value. © 2011 Blackwell Publishing Ltd.