Absence of Neurodegeneration and Neural Injury in the Cerebral Cortex in a Sample of Elderly Patients With Schizophrenia

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Abstract
A HISTORICALLY important hypothesis about the pathogenesis of schizophrenia is that it is due to a process of neural injury or neurodegeneration. This was first suggested by Emil Kraepelin,1 who emphasized the chronic deteriorating course of dementia praecox. Subsequent longitudinal studies have shown heterogeneity of outcome in schizophrenia; the conditions of some patients deteriorate, while the conditions of others improve or stabilize.2-5 Recent life-span studies of schizophrenia in late life have revealed frequent severe cognitive and functional impairments among elderly patients who are chronically institutionalized.6,7 However, not all investigators find cognitive decline over time,8-10 so further clinical and neurobiological study of this possibility, as well as its presumed neurodegenerative substrate, is warranted.