The neurodevelopmental basis of schizophrenia: clinical clues from cerebro-craniofacial dysmorphogenesis, and the roots of a lifetime trajectory of disease.
A "read-back" analysis of schizophrenia, from chronic illness, through the first psychotic episode, to psychosocial and neurointegrative abnormalities of childhood and infancy, leads to the intrauterine period as a primary focus for etiological events. Evidence for a characteristic topography of cerebro-craniofacial dysmorphology in schizophrenia is reviewed, and interpreted to estimate: (i) the timing of dysmorphic event(s); (ii) the nature of early cellular and molecular mechanisms which might determine that topography of dysmorphogenesis; and (iii) the population homogeneity of these processes. It is argued that early cerebro-craniofacial dysmorphogenesis in schizophrenia should be conceptualized as a first stage not in a static but rather in a dynamic, lifetime trajectory of disease.
Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin, Ireland.
J L
JL
Waddington
A
A
Lane
C
C
Larkin
E
E
O'Callaghan
D001921:Brain / Q000002:abnormalities* / Q000503:physiopathology*; D002675:Child, Preschool; D003398:Craniosynostoses / Q000150:complications*; D018450:Disease Progression; D005315:Fetal Diseases / Q000196:embryology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008429:Maternal Welfare; D012559:Schizophrenia / Q000209:etiology* / Q000503:physiopathology*