Brazilian Journal of Psychiatry ()

Heterogeneous trajectories in schizophrenia: insights from neurodevelopment and neuroprogression models

  • Ramiro Reckziegel,
  • Letícia S. Czepielewski,
  • Mathias Hasse-Sousa,
  • Dayane S. Martins,
  • Maria J. de Britto,
  • Clara de O. Lapa,
  • Alexandre W. Schwartzhaupt,
  • Clarissa S. Gama

DOI
https://doi.org/10.1590/1516-4446-2020-1670

Abstract

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The notion that schizophrenia is a neuroprogressive disorder is based on clinical perception of cumulative impairments over time and is supported by neuroimaging and biomarker research. Nevertheless, increasing evidence has indicated that schizophrenia first emerges as a neurodevelopmental disorder that could follow various pathways, some of them neuroprogressive. The objective of this review is to revisit basic research on cognitive processes and neuroimaging findings in a search for candidate keys to the intricate connections between neurodevelopment and neuroprogression in schizophrenia. In the complete panorama, schizophrenia is a neurodevelopmental disorder, possibly associated with an additional burden over the course of the disease through pathologically accelerated aging, and cognitive heterogeneity may explain the different trajectories of each patient.

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