What is it about?
Schizophrenia (SZ) is linked to increased chances of having cognitive issues for life, age-related diseases, and earlier death. We wanted to find out if SZ causes the brain to age faster. To do this we looked at data from 26 cohorts from around the world with 2803 SZ patients (average age 34.2 years; range 18–72 years; 67% male) and 2598 healthy people (average age 33.8 years, range 18–73 years, 55% male). We used MRI scans to measure differences between the brain of people with SZ and healthy people. We looked at the thickness and surface area of the cortex, 7 subcortical volumes, ventricular volume, and total brain volume. The difference between a person's actual age and their predicted age based on a measuring model including all the above variables was called 'brain-PAD'. On average, people with schizophrenia had a higher 'brain-PAD' than healthy people; this difference was of of +3.55 years (95% CI: 2.91, 4.19; I2 = 57.53%) after adjusting for age, sex, and site, suggesting advanced structural brain ageing in SZ. The brain-PAD in people with SZ was not linked to age, how long someone had been sick, how bad their symptoms were, or what medications they took. The study showed that people with SZ have more advanced structural brain aging than healthy people.
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Why is it important?
This study provides evidence of advanced structural brain ageing in individuals with schizophrenia, which is a well-known risk factor for cognitive impairment, chronic disease, and premature mortality. These findings may help to explain some of the cognitive and physical health problems that are commonly seen in individuals with schizophrenia and suggest the need for earlier and more targeted interventions to prevent or delay these negative outcomes. Additionally, this study adds to our understanding of the underlying biology of schizophrenia and its associated cognitive and physical health outcomes. By examining brain ageing in a large sample of individuals with schizophrenia, this study provides insights into the potential mechanisms underlying cognitive impairment and other negative health outcomes in this population. This may help to identify new targets for intervention and prevention, and ultimately improve the long-term health outcomes of individuals with schizophrenia. Overall, this study is a contribution to our understanding of schizophrenia and its associated health outcomes, and it highlights the need for further research to better understand the underlying mechanisms and develop effective interventions.
Perspectives
The study on advanced brain ageing in schizophrenia provides valuable insights into the biological underpinnings of this complex disorder. At the same time, this study highlights both the strengths and limitations of current brain imaging research in understanding mental illness. One strength of this study is its use of large-scale collaborative efforts to collect data from multiple cohorts around the world. This approach helps to increase the generalizability of the findings and highlights the importance of collaboration and sharing data in advancing scientific knowledge. Moreover, the use of brain imaging techniques to estimate brain ageing provides a unique and innovative way to study the underlying mechanisms of schizophrenia. However, this study also has limitations. For instance, similar to the vast majority of current brain imaging studies, our study does not investigate the causality of the investigated association, specifically between advanced brain ageing and schizophrenia. The study does not answer whether schizophrenia itself causes advanced brain ageing or if advanced brain ageing is a pre-existing risk factor for developing schizophrenia. Moreover, the study only focuses on brain ageing and does not examine the broader social and environmental factors that contribute to the development and progression of schizophrenia. Our results also raise important ethical and philosophical questions about how we conceptualize and treat individuals with schizophrenia. For example, the study highlights the need for earlier and more targeted interventions to prevent or delay cognitive and physical health problems associated with schizophrenia. However, this raises important questions about the potential for further stigmatization and discrimination against individuals with schizophrenia based on their perceived risk for negative health outcomes. Overall, our study provides important food for thought for both scientists and society at large. It highlights the strengths and limitations of brain imaging research in understanding mental illness, while also raising important ethical and philosophical questions about the social and environmental factors that contribute to the development and progression of schizophrenia.
Professor of Clinical Psychiatry Adrian PREDA
University of California Irvine
Read the Original
This page is a summary of: Brain ageing in schizophrenia: evidence from 26 international cohorts via the ENIGMA Schizophrenia consortium, Molecular Psychiatry, December 2022, Springer Science + Business Media,
DOI: 10.1038/s41380-022-01897-w.
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