53-55 Preliminary support for the idea they may be indirect indicators of aberrant brain development came from Van Os et al,56 who reported an association between dermatoglyphic ridge counts and cerebral structural abnormalities measured by magnetic resonance imaging (MRI) in patients with schizophrenia. Similarly, compared with controls, patients with schizophrenia present a dermatoglyphic deviance (excessive fluctuating asymmetry of ridge counts), which correlates with their excessive mixed handedness. Inhibitors,research,lifescience,medical These can be interpreted as two related

markers pointing toward greater developmental instability in schizophrenia.57 Are the brain deviances in schizophrenia developmental in origin? The most consistent deviances described in schizophrenia are an increase in ventricular

size and subtle global and regional cortical volume reductions.58-62 Wright et al63 carried out a meta-analysis of 58 MRI studies, which included 1 588 patients with schizophrenia. The mean lateral ventricular Inhibitors,research,lifescience,medical volume was greater (126 %) than that of controls and the mean cerebral Inhibitors,research,lifescience,medical volume was smaller (98 %). Relative to the cerebral volume reductions, the regional volumes of the subjects with schizophrenia were 98 % for the frontal lobes, 94 % for the amygdala/hippocampus, and 96.5 % for the thalamus. Recently, PD184352 voxel-based methods of analyzing structural MRI images have enabled the whole brain to be examined, and implicated particularly the medial temporal region, insula, and anterior cingulate.64,65 Certainly, brain changes are present near to the onset of the frank psychosis. This is demonstrated by the numerous reports of ventricular enlargement and other deviations in first-onset cases of schizophrenia66-68 Inhibitors,research,lifescience,medical and in earlyonset cases too.69,70 Furthermore, there is an excess of congenital lesions in patients with schizophrenia, such Inhibitors,research,lifescience,medical as aqueduct stenosis, arachnoid and septal cysts, and agenesis of the corpus callosum and cavum septum pellucidum.71,72 However, such

abnormalities are distinctly unusual and the findings are generally much more subtle. Indeed, it is an open question whether these differences in brain structure found between people with schizophrenia and normal subjects are “brain abnormalities,” which are an intrinsic part of the disease process itself. Alternatively, they might be heptaminol regarded as deviations within the normal range, which increase the risk of developing schizophrenia. One piece of evidence does, however, point to fetal life. The normal brain is typically asymmetrical, and the development of brain asymmetry is usually complete by the middle of the third trimester of gestation. A number of studies revealed a reduced asymmetry in several brain areas in schizophrenia.73-75 A recent meta-analysis, reviewing handedness, language, and anatomical studies, confirms the decreased anatomical and functional cerebral lateralization in schizophrenia.