Neurobiol Dis 2019 11 10;131:104322. Epub 2018 Nov 10.
Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
Cognitive functions including social cognition improve significantly during adolescence, the time period during which the brain typically handles a large volume of incoming information from the outside environment. Processing information and responding to environmental challenges allow the prefrontal cortex, a brain region important for cognition, to mature further and establish self-identity, social skills, and other cognitive abilities, thus helping individuals to function in society. People with vulnerable circuitries predisposed by either genetic or early environmental insults, may not be able to deal with social situations appropriately, and develop network dysfunction that may lead to the onset of schizophrenia, which often occurs during this period. Populations with higher risk for developing schizophrenia present "prodromal" phenotypes, including cognitive deficits, even before the onset of the disorder. Modulating circuit plasticity when the prefrontal cortex is particularly vulnerable allows us to support the development of cognitive functions in such populations and prevent them from transitioning into full-blown schizophrenia. For this approach to be successful, we need to conduct both human and animal studies side by side to better understand the neurobiology underlying the disorder, especially changes that occur over the disease trajectory that may be clinically relevant. By taking a multidisciplinary approach, there is a hope for precision medicine for schizophrenia in the future.