Understanding aberrant white matter development in schizophrenia: an avenue for therapy?

Abstract

Although historically gray matter changes have been the focus of neuropathological and neuroradiological studies in schizophrenia, in recent years an increasing body of research has implicated white matter structures and its constituent components (axons, their myelin sheaths and supporting oligodendrocytes). This article summarizes this body of literature, examining neuropathological, neurogenetic and neuroradiological evidence for white matter pathology in schizophrenia. We then look at the possible role that antipsychotic medication may play in these studies, examining both its role as a potential confounder in studies examining neuronal density and brain volume, but also the possible role that these medications may play in promoting myelination through their effects on oligodendrocytes. Finally, the role of potential novel therapies is discussed.

Keywords::

• antipsychotic medication
• dysmyelination
• myelin
• oligodendrocytes
• promyelinative
• schizophrenia
• white matter

Financial & competing interests disclosure

Mark Walterfang has received funding from the Stanley Medical Research Institute, Pfizer Pharmaceuticals and Bristol Myers-Squibb for research on white matter changes in schizophrenia. Thomas Whitford is supported by an Overseas-Based Biomedical Training Fellowship from the National Health and Medical Research Council of Australia (NHMRC 520627), and a Young Investigator Award from the Brain and Behavior Research Foundation (NARSAD 17537). Christos Pantelis was supported by a NHMRC Senior Principal Research Fellowship (ID: 628386) and NHMRC Program Grant (ID: 566529). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.