Author: Aldanova Aziza
Translated by: Turarova Aiym
In the world, about 20 million people suffer from multi-factorial mental disorder, such as schizophrenia, which develops with a gradual increase in personality change and under the influence of other negative emotions. The etiology and pathogenesis of schizophrenia has been established hypothetically, and the disease itself can be treated with atypical antipsychotics and psychosocial support, but not all. Scientists from the School of Medicine of the University of Pennsylvania published an article in the “Brain” neurological journal on the found second subtype of schizophrenia. In the future, this may serve as an innovation in the neuroanatomical theory of pathogenesis and make changes in treatment.
People with schizophrenia may be hallucinations, disorganization of thoughts, in which patients abruptly switching from one topic to another without realizing it. This is one of the symptoms of schizophrenia, there are others which manifest themselves through the violation of abstract thinking, memory and learning, dystrophy, anxiety, agitation, and suicidal tendencies and thoughts. There are many ways to diagnose schizophrenia, in the main, these methods aimed to study the clinical manifestations. One of these methods is carried out on the basis of the “four A” principle, Bleuler and “flattening” of affect; impaired associative processes; autism; ambivalence (the violation of emotional reactions), such as hallucination, delusions and other scientists refer to the symptoms of “second rank”, arguing that they may appear in other mental diseases. At the moment many people with the disease receive proper treatment, which helps to eliminate only the symptoms, not the disease itself, and this method is not suitable for all patients. The reason for the failure of treatments for schizophrenia is the lack of specificity, universally accepted pathogenesis, which creates gaps in the concept of the mechanism of action of drugs on the disease.
There are theories of pathogenesis in which stress, genetic predisposition, and neurochemical, neuroanatomic, immunological, and psychosocial concepts are key factors. Schizophrenia is genetically transmitted and developed under adverse environmental conditions. By focusing on neuroanatomical theory, brain scientists determine the dysfunction of the frontal and limbic zones. The MRI and CT detect changes in the brain such as dilation of the lateral and third ventricles, atrophy of the cortex, dysfunction of the frontal lobe of the limbic lobes and basal ganglia, and intrapolar asymmetry. According to the results of the EGG, patients with schizophrenia suffered lower voltage from frontal excretion in nuclear forms of schizophrenia. This pathology suggests a left brain disorder. Professor René Kahn, in his paper at a conference in Portugal, conjectured that schizophrenia causes progressive loss of gray matter in the early stages of the brain, which has since weakened the effect with atypical neuroleptics. Numerous studies show that schizophrenia changes and decreases the size of brain structures.
In 2020, scientists from Pennsylvania found that schizophrenia did not necessarily change the volume of gray matter and other structures. In a study of 300 participants, two subtypes of schizophrenia were identified. In patients with the first subtype, there were changes in the sulfur matter volume and brain structure, while in the second half of the patients, the sulfur matter was substantially normal in volume and this change was called the second subtype. To better characterize structural differences, lead researcher Christos Davaatzikoz formed a consortium covering three continents of the US, China, and Germany. The international team consisted of 307 patients with schizophrenia and 364 healthy people, all aged 45 and younger. The machine learning method "HYDRA" (heterogeneity through discriminatory analysis) was used, developed by engineers to identify the "true subtype" taking into account gender, age, visualization protocols and other factors. As a result, it was found that almost 40% of patients with schizophrenia did not have a typical gray matter pattern, but a normal anatomical structure, except for the large basal ganglia and the inner capsule. Doctors have been unable to find a link between drug use, age and the continent. Davaatzikoz did not conceal his shock and confusion, but in one thing he was certain: in the near future they would not say "this man is schizophrenic" but would classify "he has this subtype or pattern". Consequently, they will not unite all people with schizophrenia and treat them with the same antipsychotic drugs. Future research will also focus on brain structure anomalies, revealing a clear clinical picture and progression of disease and etiology.
In conclusion, this discovery casts doubt on the notion that brain volume loss is a feature of schizophrenia. Despite these problems, there are new ways to study pathogenesis and etiology that will help to develop a strategy for treating patients with schizophrenia. We hope that with the beginning of understanding the biology of the disease there will be more personalized, informative methods of treatment, and doctors will not throw themselves into "darkness" in the hope that it will work.
