4 The field of schizophrenia research has a rich history of investigating physical developmental anomalies as potential clues linked to the enigmatic development of the disorder and perhaps to the pathophysiology of its intriguing symptoms. The notion that early brain insults predispose to schizophrenia is supported by findings that some patients with the disorder exhibit morphologic evidence of subtle developmental abnormalities that presumably occurred during embryogenesis. 1–3 Therefore, these changes occur well before the onset of psychotic symptoms that typically first appear in late adolescence or young adulthood. The neurodevelopmental model of schizophrenia proposes that both genetic and environmental factors contribute to structural and functional brain changes in the intrauterine and perinatal periods, as well as in childhood and early adolescence. Minor physical anomalies, psychosis, schizophrenia Introduction Taken together, research findings on MPAs indicate that these minor anomalies are indeed part of some schizophrenia syndromes, representing a stable systemic or physical set of manifestations of the underlying neurodevelopmental processes that lead to the illness. It remains to be determined whether MPAs-which, of course, are fixed markers present throughout childhood and adolescence well before the onset of the prodrome and psychosis-may have utility in terms of risk stratification for future preventive efforts. Given the availability of more sophisticated microarray technologies, and in light of recent findings on spontaneous mutations in patients with schizophrenia, it is possible that MPAs will prove to be useful in identifying etiologic subtypes and/or the loci of genetic risk factors. The broadly defined, heterogeneous MPA construct may be of limited value in further elucidating the specific pathophysiology of schizophrenia, though particular anomalies, such as those pertaining to nasal volumes, palatal abnormalities, or craniofacial morphology, may be informative. This review synthesizes select areas of research findings on MPAs to address the question, Are MPAs part of the syndrome of schizophrenia? Although MPAs are not specific to schizophrenia, their presence in some patients indicates that aberrations in the development of the nervous system contribute to risk for the disorder. The well-documented excess of minor physical anomalies (MPAs) among individuals with schizophrenia generally supports the neurodevelopmental model, which posits that both genetic and environmental factors contribute to structural and functional brain changes in the intrauterine and perinatal periods that predispose one to developing schizophrenia.
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