Questions Regarding ‘Brain Change’ Study

A worrisome article has appeared in The Chicago Tribune on a Dr. John Csernansky and his colleagues of Northwestern University’s Feinberg School of Medicine in Evanston, Illnois, conducting a study to help better diagnose schizophrenia.

“Diagnosing schizophrenia is more of an art than a science,” said Csernansky, who heads Northwestern’s psychiatry and behavioral sciences department, “but by using a computer to chart subtle changes in the brain from [magnetic resonance imaging], we can create brain maps. We still don’t know why the disease is degenerative, but we can now see patterns. Even in the absence of obvious deterioration of behavior, we can see biological progression of the disease.”

Had this doctor said of his research, as he says of diagnosis, that it is more of an art than a science, I would feel even more queasy about the article than I do now, and I find this approach to research very disturbing.

A woman, Mrs. Gertie Rodig, hopes it will help other people deal with situations such as that which took the life of her son.

Many patients go undiagnosed and/or untreated, such as Don Rodig, who died four years ago at age 50 after a tumultuous few years with the disease, said his mother, Gertie Rodig of Arlington Heights. “He tried to commit suicide four times and had a mental breakdown,” Rodig said, “but when we took him to the hospital, he would check himself out.”

Though he had symptoms such as hearing voices and believing the FBI was watching him, Rodig said her son never received medication.

My concern is that unless this research team includes people diagnosed schizophrenic who aren’t on psychiatric drugs (medications) in its study, it will not be able to rule out whether the ‘deterioration’ that takes place in its subjects is due to the use of these psychiatric drugs, or ‘the progression of the disease’ as Dr. Csernansky puts it.

Much evidence exists to support the conclusion that the drugs used to treat schizophrenia actually cause much of the damage attributed to the disease itself.

When psychiatrists have only one primary method of treatment, drug maintenance, it becomes very difficult to find any patients who have not at one time or another been maintained on psychiatric drugs. Until such time as some portion of the patients used in such a study are not being maintained on psychiatric drugs, we cannot rule out the drugs as the source of the damage seen in the MRI scans.

Treatment of schizophrenia includes antipsychotic medications and psychotherapy. By comparing the disease progression with treatment, Csernansky said, the study will help show how medications affect or do not affect the schizophrenic brain.

Okay, but not unless it includes ‘the disease progression’, if any, without treatment.

Another question I have regards the ties Dr. Csernansky might have to the pharmaceutical industry. Is his research heavily industry funded? The US Senate is currently investigating the financial links a number of prominent researchers in this country have to the pharmaceutical industry. It is always possible that Dr. Csernansky’s scientific curiosity is tainted with self interest, and that it is somewhat less impartial and unbiased than it would appear to be from any merely cursory examination.