Previous medications for schizophrenia have primarily been effective against delusions and hallucinations. However, many sufferers still struggle to cope with everyday life despite medication because other symptoms persist: listlessness, social withdrawal, and difficulties with thinking and concentrating. Two researchers at the DZPG site in Munich-Augsburg are addressing precisely this issue – with new approaches designed to repair the underlying disorders in the brain.
An old allergy medication put to new use
Dr Isabel Maurus from the Clinic for Psychotherapy and Psychiatry at LMU Munich is researching an important disorder in schizophrenia: the impaired insulation of nerve pathways in the brain. Normally, nerve fibres are surrounded by a protective layer. This layer, called myelin, ensures that signals are transmitted quickly and reliably. In people with schizophrenia, this protective layer is often too thin, especially in areas of the brain that are important for thinking, planning, and social behaviour.
In her study, Maurus combines exercise training with clemastine, a drug that has been used to treat allergies since the 1960s. Multiple sclerosis research has shown that clemastine can help rebuild the protective layer of the nerves. Unlike previous schizophrenia medications, clemastine attacks the problem directly where it arises – in the cells themselves.
Around 90 patients are taking part in the study and receiving either clemastine, an exercise programme – or both. The initial results are promising: ‘We are seeing improvements in cognition and negative symptoms,’ says Maurus.
The patient's own nerve cells under the microscope
Dr Florian Raabe from the Max Planck Institute of Psychiatry is taking a different approach: he is investigating how well the connections between nerve cells, the synapses, function in schizophrenia. ‘Schizophrenia was long considered a degenerative disease. Today, a different picture is emerging: it is not cell death, but rather faulty development and impaired remodelling that are at the forefront,’ explains Raabe.
His team uses a special method: nerve cells are grown in the lab from patients' skin cells. ‘This technology gives us the opportunity to examine human nerve cells from our psychiatric patients in vitro for the first time,’ says Raabe. These nerve cells grown in the laboratory show the same problems as in the brains of patients – for example, too few connections between the cells.
These cells can also be used to test drugs. Previous studies have shown that only the cells of patients who responded to a drug during treatment responded to it in the laboratory. In the future, this could help predict which drug works best for which person.
A change of perspective in treatment
Both projects show that schizophrenia is not an unchangeable disease. The brain has the ability to recover. DZPG spokesperson Prof. Dr. Peter Falkai says: ‘We are still in the early stages, but the potential is enormous. We are learning to specifically influence the underlying processes in schizophrenia and thus improve cognitive and social functions in the long term.’
Prof. Dr. Silvia Schneider, also a spokesperson for the DZPG, adds: ‘The aim is to develop therapies that address the biopsychosocial basis of the disease and thus also help those for whom currently available treatments have failed. These research projects are opening new avenues – individualised, cause-oriented and with a view to genuine participation for those affected.’
The full article can be read online at dzg-magazin.de.
