title: Early and late neurodevelopmental disturbances in schizophrenia and their functional consequences.
abstract: OBJECTIVE
  The evidence from structural imaging studies supports the notion that schizophrenia arises from an early abnormality in brain development. In this paper we review the timing of structural changes in schizophrenia and argue that schizophrenia is a neuro-developmental disorder with limited progressive brain changes occurring during the evolution and early phase of psychosis.
  
  
  METHODS
  The available cross-sectional and longitudinal studies are reviewed, along with data from our own research.
  
  
  RESULTS
  The current literature, including our own data, suggests that structural brain changes are apparent premorbidly, consistent with a neurodevelopmental lesion. These are prominent in frontal and cingulate regions, and appear related to premorbid neuropsychological deficits in executive function. However, there appear to be additional brain changes over the transition to illness and beyond.
  
  
  CONCLUSIONS
  We propose first, that an early neurodevelopmental insult interacts with either normal or abnormal postpubertal brain maturation to produce further (late neurodevelopmental) brain structural and functional changes; and second, that the effect of such neurodevelopmental lesions will have different consequences for functions that normally develop early in life, such as memory, compared with functions developing later, such as executive functions. A model is presented suggesting that the structural and functional abnormalities in schizophrenia can be understood as a consequence of the neurodevelopmental stage at which brain changes occur.
authors.affiliation: Cognitive Neuropsychiatry Research and Academic Unit, Sunshine Hospital, 176 Furlong Road, St. Albans, 3021, Victoria, Australia. cpant@unimelb.edu.au
authors.forename: Christos
authors.initials: C
authors.lastname: Pantelis
authors.forename: Murat
authors.initials: M
authors.lastname: Yücel
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Wood
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
authors.forename: Dennis
authors.initials: D
authors.lastname: Velakoulis
mesh_terms: D001921:Brain / Q000002:abnormalities* / Q000254:growth & development / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D006801:Humans; D008137:Longitudinal Studies; D008959:Models, Neurological; D012559:Schizophrenia / Q000209:etiology* / Q000503:physiopathology*; D013997:Time Factors