Spring 1996
Regions of abnormal metabolic activity in the brain are apparent in the PET image (left) of a patient with schizophrenia. Red areas represent increased brain activity; blue areas show decreased activity. The brain image at the right shows a control subject and normal activity in yellow in the corresponding regions of the brain. The images are from PET scans overlaid on magnetic resonance displays of brain structure.
Images courtesy Rick Mahurin, MD; Research Imaging Center
Research looks inward and outward
Faculty members from the Health Science Center are involved in a wide array of research related to schizophrenia.
On one front, experts are looking at the brain using sophisticated positron emission tomography (PET), which shows how the brain actually works.
Rick Mahurin, PhD, associate professor of psychiatry at the Health Science Center, is comparing the PET images from psychotic and healthy persons. He's trying to locate and picture the malfunction in schizophrenic brains.
Dr. Mahurin works through the Clinical Research Unit at the San Antonio State Hospital and the Health Science Center's Research Imaging Center (RIC). He's using the BrainMap data base developed by Peter T. Fox, MD, RIC director, and Jack L. Lancaster, PhD, who heads the center's computer software development team.
"We've developed computer-based tests and neural network models to study the neurocognitive function of schizophrenics," Dr. Mahurin says. "Results of our trials with patients and with normal subjects are pointing to a dysfunction in the frontal lobe of the brain which will help lead to more specific behavioral and pharmacologic treatments."
PET scans and other findings about the physical and chemical functioning in a psychotic's brain may help pinpoint the cause of residual negative symptoms that patients exhibit, even after medications have helped to clear their thinking. "Sometimes, when patients appear lazy or unproductive, for example, even on medication, it might be because they've still got cognitive deficits," says Dawn Velligan, PhD, clinical assistant professor of psychiatry. "They may always have trouble organizing and proceeding logically."
Several other researchers are converging on the social issues associated with schizophrenia. For example:
- Dr. Velligan is helping patients and their families cope with cognitive deficits, such as attention and memory problems, which remain even on medication. How can these be overcome?
- Janet Tekell, MD, clinical assistant professor of psychiatry, and Julia Vertrees, PharmD, are looking at the costs of schizophrenia. How can these be reduced?
- Delia Saldana, PhD, clinical assistant professor of psychiatry, is comparing stresses caused by a psychotic family member among urban and rural Hispanics and non-Hispanic whites. They're different. What can the two cultures learn from one another and what can both do to lessen the stress?
"Unless we can intervene with a patient's family, we are missing an important opportunity to help them," says Dr. Saldana. "We are studying English and Spanish-speaking families and patients throughout South Texas to learn what their burdens are, what contributes to their stress and how this stress can be reduced." Saldana's work is the only effort in the country to specifically study rural Mexican Americans.
The researchers are looking at everything from lack of financial resources to lack of social services or drug problems within the family. "So many family members and even professional mental health workers are operating on their good intentions only," she says. They have not had the training they need to address the problems and help to solve them. Our research is aimed at developing standards of practice that can be taught."
