Schizophrenia Bulletin Advance Access originally published online on October 17, 2007
Schizophrenia Bulletin 2008 34(1):18-29; doi:10.1093/schbul/sbm110
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Limbic Structures and Networks in Children and Adolescents With Schizophrenia
2 Department of Psychiatry
3 Center for Magnetic Resonance Research
4 Center for Neurobehavioral Development
5 Institute of Child Development
6 Department of Psychology, University of Minnesota, Minneapolis, MN
1 To whom correspondence should be addressed; Division of Child and Adolescent Psychiatry F256/2B, Department of Psychiatry, Fairview University Medical Center, University of Minnesota, 2450 Riverside Avenue, Minneapolis, MN 55454; tel: 612-273-9762, fax: 612-273-9779, e-mail: twhite{at}umn.edu.
Studies of adults with schizophrenia provide converging evidence for abnormalities in the limbic system. Limbic structures that show consistent patient/control differences in both postmortem and neuroimaging studies include the anterior cingulate and hippocampus, although differences in the amygdala, parahippocampal gyrus, and fornix have also been observed. Studies of white matter in children and adolescents with schizophrenia tend to show findings that are more focal than those seen in adults. Interestingly, these focal abnormalities in early-onset schizophrenia tend to be more localized to limbic regions. While it is unclear if these early limbic abnormalities are primary in the etiology of schizophrenia, there is evidence that supports a developmental progression with early limbic abnormalities evolving over time to match the neuroimaging profiles seen in adults with schizophrenia. Alternatively, the aberrations in limbic structures may be secondary to a more widespread or global pathological processes occurring with the brain that disrupt neural transmission. The goal of this article is to provide a review of the limbic system and limbic network abnormalities reported in children and adolescents with schizophrenia. These findings are compared with the adult literature and placed within a developmental context. These observations from neuroimaging studies enrich our current understanding of the neurodevelopmental model of schizophrenia and raise further questions about primary vs secondary processes. Additional research within a developmental framework is necessary to determine the putative etiologic roles for limbic and other brain abnormalities in early-onset schizophrenia.
Keywords: limbic system / children / adolescents / schizophrenia / hippocampus / medial temporal lobe