MRI findings and clinical outcomes in schizophrenia

While differences in brain structure have been identified in groups of individuals with schizophrenia, it has remained unclear to what extent these findings contribute to the clinical features of the illness. Whether one is investigating symptoms, cognitive functioning, treatment response or longer-term outcomes, it has been difficult to identify consistent clinical correlates of the reported structural brain abnormalities. This is likely due in part to issues related to sample selection as well as to difficulties in how both brain measures and clinical measures are applied. Typically, associations are sought between multiple measures of brain structure and multiple clinical measures. When associations are identified as statistically significant, it is often unclear whether the associations are truly specific to a particular brain region or clinical domain. That both brain measures and clinical measures may be changing over time further complicates the interpretation of such findings. Understanding the relationship between brain structure and clinical outcomes in schizophrenia is important both for understanding the disease mechanisms underlying schizophrenia and in conceptualizing the factors that contribute to the potential for recovery. Innovative statistical approaches may be critical to uncovering these relationships in ways that help us appreciate whether the clinical features are mediated in meaningful ways by measures of brain anatomy.