Schizophrenia, it’s all in the mind?

… the brains behind a new two year study, think not.

This is the lead image of the latest news post from Mental Health Charity The Chy Sawel Project, championing an holistic approach to treating anxiety, depression and stress.

Brain images showing elevation in microglial activity in orange/red. The highest levels in schizophrenia are in the frontal cortex and the temporal cortex.
Photograph: MRC London Institute of Medical Science

British scientists have begun testing a radically new approach to treating schizophrenia based on emerging evidence that it could be a disease of the immune system.

During the next two years, 30 patients will receive monthly infusions of an antibody drug currently used to treat multiple sclerosis (MS), which the team hopes will target the root causes of schizophrenia in a far more fundamental way than current therapies.

This is a supplementary image from the latest news post by Mental Health Charity The Chy Sawel Project, championing an holistic approach to treating anxiety, depression and stress.

Professor Oliver Howes

The trial builds on more than a decade’s work by Oliver Howes, a professor of molecular psychiatry at the MRC London Institute of Medical Sciences and a consultant psychiatrist at the Maudsley Hospital in south London. Howes’s team is one of several worldwide to have uncovered evidence that abnormalities in immune activity in the brain may lie at the heart of the illness.

Recent work by Howes and colleagues found that in the earliest stages of schizophrenia, people experience a surge in the number and activity of immune cells in the brain. As well as fighting infection, these cells, called microglia, have a “gardening” role, pruning unwanted connections between neurons.

But in schizophrenia patients, the pruning appears to become more aggressive, leading to vital connections being lost. The most extensive pruning appears to occur in the frontal cortex, the brain’s master control centre, and also the auditory regions, which could explain why patients often hear voices. The frontal cortex indirectly controls the brain’s levels of dopamine – a surge in this brain chemical is thought to explain the delusions and paranoia experienced by those with schizophrenia.

Nearly all existing medications work by blocking dopamine, which can bring psychotic symptoms under control, but fail to protect the brain’s basic architecture from damage.

There is a growing appreciation that other, perhaps less well-known, symptoms associated with schizophrenia, memory and cognitive problems, and lack of motivation; can have an equally profound impact on patients and existing drugs do little to help this side of the disease.

This is a supplementary image from the latest news post by Mental Health Charity The Chy Sawel Project, championing an holistic approach to treating anxiety, depression and stress.

Microglial cells, outlined in green stain, have thin processes that reach out around brain cells, stained in red.
Photograph: Bloomfield et al

The latest trial, a collaboration between MRC scientists and King’s College London, involves treating patients with a monoclonal antibody drug, called Natalizumab, that is already licensed for MS. In MS, the brain’s immune cells go awry by attacking a different aspect of the brain’s wiring. And although the diseases manifest in very different ways, apparent parallels in the underlying biology raise the possibility that the MS drug might help schizophrenia patients.

The drug works by targeting microglia and restricting their movement around the brain, which scientists hope could prevent the over-pruning of vital connections. In doing so, it could potentially address the disease’s full spectrum of symptoms.

 

This image displays the logo of Mental Health Charity The Chy Sawel Project, championing an holistic approach to treating anxiety, depression and stress.To find out more about the trial, please visit the MRC website here…

One of the key aims of The Chy Sawel Project is to promote research that challenges assumption about mental health conditions. If you believe in challenging these assumptions too and would like to help, please click here.

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