By Amy Norton

NEW YORK, Mar 23 (Reuters Health) - Men with schizophrenia appear to lose small amounts of brain volume over time, with the most pronounced changes turning up in the most severely ill patients, according to new study findings. If such slowly developing brain changes commonly occur in schizophrenics, this would raise the possibility of halting the disease somewhere in its progression, researchers speculate.

Schizophrenia is a psychiatric disorder marked by hallucinations, delusions, and overall withdrawal from reality. Symptoms typically surface in the late teens and early-20s in men, and somewhat later for women. The exact cause of schizophrenia is unknown, but experts believe a combination of genetic, environmental and developmental factors conspire to trigger it. Research has uncovered structural abnormalities in schizophrenics' brains--but when, why and how often they arise is unknown.

The current findings, published in a recent issue of the Archives of General Psychiatry, suggest that these structural changes may occur over time after schizophrenia symptoms first appear.

If such progressive brain degeneration is involved in schizophrenia, "it would give hope that some type of intervention might arrest the process," Dr. Daniel H. Mathalon said in an interview.

Mathalon, now at Yale University in New Haven, Connecticut, was at Stanford University in California when he led the current study.

He and his colleagues studied brain scans of 24 men with schizophrenia, and compared them with those of 25 healthy men. To observe brain changes over time, two sets of scans were taken 4 years apart. Mathalon's team found that not only did schizophrenic men show greater brain volume loss, but the rate of tissue loss was also directly related to the severity of the patients' symptoms.

What this means is unclear, but Mathalon said some experts believe that the hallucinations and other severe symptoms of schizophrenia reflect a toxic process going on in the brain. But, he said, the idea that the disease involves slowly developing brain abnormalities is controversial.

"You have to put this in the context that 30 years ago, it was debated whether this was a brain disease," he explained. That is, some experts believed schizophrenia was a psychological problem with no actual brain damage.

Brain imaging technology developed since then has changed that view. But it remains unclear whether structural abnormalities arise during brain development and stay unchanged or progress throughout patients' lives.

If the latter is true, according to Mathalon, it may be possible to improve the outlook for patients by developing drugs that halt this brain degeneration. Or, more immediately, getting schizophrenics to stick with their standard antipsychotic drugs may help.

"Right now, we say do it to control your symptoms," Mathalon said. "But it may be that if they stay on medications that control symptoms, (brain abnormalities) will progress less."

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