Schizophrenia may begin in the brain of the fetus with a defect in some of the cells that control emotion, according to scientists at UCLA.
Some crucial pyramid-shaped cells in schizophrenics' brains are out of alignment by as much as 180 degrees, Drs. Arnold Scheibel and Joyce Kovelman of UCLA's Brain Research Institute report.
"This kind of disorientation does not occur after the fetal period," said Scheibel, because after birth the cells are locked in place by surrounding cells and other brain matter.
Scheibel and Kovelman say they believe that the jumble of cells could be caused by some kind of trauma in the womb, perhaps a lack of oxygen, a virus or a genetic defect.
Schizophrenia, literally "split personality," is the name of an array of symptoms that range from the loss of touch with reality through hallucinations to a withdrawal from almost all speech and activity.
The Scheibel-Kovelman research is the latest in a decade of discoveries indicating that many mentally ill patients suffer from abnormal chemistry or disorganized signals within their brains.
In an interview yesterday Scheibel said that his findings are the most solid evidence yet that schizophrenics have physical or structural abnormalities in their brains.
But he also emphasized that schizophrenia almost certainly has multiple and perhaps complex causes.
He said that physical abnormalities might only mean that a person has the potential for developing the illness, a potential that that could be activated by the emotions and stresses of daily living.
Scheibel examined more than a dozen brains of lifelong schizophrenics who died at a state hospital.
In brain after brain he found what he calls "a very dramatic disorientation of the pyramidal cells of the hippocampus," pyramid-shaped cells in a part of the limbic system, an area of memory and emotion immediately underlying the brain's outer cortex, or "thinking cap."
"There was marked disorientation of the pyramidal cells and their dendrites," short antenna-like tendrils that receive nerve impulses, he said. "The pyramidal cells should be lined up in rather elegant palisades, with all their dendrites organized vertically. In these patients, the cells and dendrites were linked up at odd angles, often off by 90 degrees or more or even 180 degrees in the sicker patients."
Later, Scheibel and Kovelman made painstaking microscopic examinations of the brains of 10 25-to-67-year-old schizophrenics who had died at Wadsworth Veterans Hospital in Los Angeles. They compared these brains with those of eight men who died of non-psychotic, non-neurological illnesses.
There were mild disarrays in the brains of half of the non-psychotics, but severe and dramatic ones in all 10 schizophrenics.
What "we are suggesting," Kovelman said, is that "perhaps there is a continuum from normal to mild to severely disturbed," and most people may have some modest hippocampal disarray, "but the central nervous system can compensate for it" unless the disarray--or the stress of life--is too great.
Most of the schizophrenics studied had paranoid schizophrenia, which is schizophrenia accompanied by hallucinations or unfounded feelings of persecution or grandeur. But the majority of schizophrenics wander in and out of paranoia, Scheibel said, and "we believe our findings apply to schizophrenia generally."
The number of brains examined is still small, Scheibel said. Yet, Kovelman said that is nonetheless "the first quantified study, made under very rigid and controlled conditions" to find such structural changes.
"I would like to look at many more brains," Scheibel said. "The whole field of schizophrenia is in unrest today. When it comes to understanding, we're where we were with the pneumonias 75 years ago."
Still, Dr. Frederick Goodwin at the National Institute of Mental Health here said that there has been a series of studies in about the last 10 years indicating that some untoward events in the womb "may be involved in the etiology assignment of a cause of some forms of schizophrenia." He praised Scheibel as a "very good worker, very careful."
The brain-cell disarray is currently untreatable.