Di Biase, MA; Pantelis, C; Zalesky, A; Kubicki, M; Shenton, ME
(Springer Nature, 2020-01-01)
Significant effort has been devoted to characterizing white matter pathology in patients with schizophrenia and its impact on brain connectivity (Samartzis et al., J Neuroimaging 24(2):101-10, 2014; Fusar-Poli et al., Neurosci Biobehav Rev 37(8):1680-91, 2013; Bora et al., Schizophr Res 127(1):46-57, 2011). This is particularly important in light of the disconnection hypothesis-a key etiological theory of schizophrenia suggesting that symptoms arise from a failure of integration between distinct brain regions (Friston, Schizophr Res 30(2):115-25, 1998). In this chapter, we focus on neuroimaging evidence demonstrating structural white matter alterations in schizophrenia. Key questions addressed include: what methods are sensitive to the pathophysiology of schizophrenia? What is the evidence that white matter pathology emerges prior to or near to the onset of psychosis? Is the trajectory of white matter pathology stable or, alternatively, a dynamic process, with progressive changes evident over the course of illness? What are the limitations of these studies? How does neuroimaging evidence relate to micro- and meso-structural white matter findings?.