A study examined the brains of children at increased risk of developing schizophrenia to determine whether signs of vulnerability can be detected during childhood. The findings suggest that subtle brain differences may emerge before the onset of symptoms. Understanding these changes could help identify early warning signs and support the development of more effective interventions.

Over recent decades, researchers have sought to identify early indicators of schizophrenia before the appearance of clinical symptoms, to develop more effective detection and intervention strategies. However, most studies have focused on adolescents or adults already considered to be at high risk, making it difficult to determine when the earliest brain changes associated with vulnerability to the disorder first emerge.

Although heredity plays an important role in the risk of developing schizophrenia, family history alone is not sufficient to identify all individuals who may be vulnerable to the disorder. It is therefore essential to study children at earlier stages of development, before the onset of clinical symptoms or significant functional difficulties.

In this context, with support from the Bial Foundation, Kristin Laurens (King’s College London, UK) led an international team of researchers who analysed the brains of 88 children aged between 9 and 12 years to assess whether signs of risk can be detected during childhood, before clear symptoms of schizophrenia emerge.

Based on the longitudinal Child Health and Development Study (CHADS), the research was conducted over four years using magnetic resonance imaging (MRI) to monitor changes in the volume of the brain structures under investigation. The children were divided into three groups: one comprising children with multiple early risk factors associated with schizophrenia, another including children with a family history of the disorder, and a third consisting of typically developing children.

In the article “Trajectories of grey and white matter volume in children at elevated risk for schizophrenia”, published in the scientific journal CNS Spectrums, the authors report that the brains of children with risk factors associated with schizophrenia may exhibit subtle structural differences even before the onset of psychotic symptoms or a diagnosis of the disorder. Both children presenting multiple early antecedents associated with schizophrenia risk and those with a family history of schizophrenia showed greater overall white matter volumes (the brain tissue involved in communication between different brain regions) compared with their typically developing peers. This pattern persisted across successive assessments, suggesting that these differences may emerge very early in brain development.

In addition, children with a family history of schizophrenia showed differences in the trajectory of grey matter volume (the brain tissue involved in information processing) over the two-year follow-up period, although there was some indication of a tendency towards normalisation over time. However, these differences in grey matter volume trajectories did not remain statistically significant after correction for multiple comparisons, highlighting the need for larger studies to confirm this finding.

Although the findings should be interpreted with caution due to the study’s relatively small sample size, the researchers argue that the study reinforces the importance of early screening in children who do not yet present significant clinical symptoms. “It is essential to establish systematic follow-up assessments and personalised intervention strategies that enable more accurate evaluation and stratification of the risk of developing schizophrenia in these children, thereby contributing to a more effective early intervention model”, emphasises Kristin Laurens.