As demonstrated in the previous four chapters, neuroimaging technologies have revolutionized our capacity to study schizophrenia and our understanding of its neural substrates and neural mechanisms. At the end of the first decade of the twenty-first century, it seems appropriate to take stock of how far we have in fact come.

The “Dark Ages” of schizophrenia research

When I began my career as a schizophrenia researcher in the mid 1970s, we had no way to directly study the malfunctioning organ that was producing the illness: the brain. In fact, it did not occur to most psychiatrists that the brain was the organ that they should study! The field of “biological psychiatry” was engaged in a fruitless examination of peripheral metabolites, such as platelet monoamine oxidase – a very remote window into the brain. As a young student of schizophrenia, I instead chose to study language and cognition, because they seemed to me to be a better window, since they at least clearly reflected the functional activity of the brain.

When I saw my first Computerized Tomography (CT) scan around this time, however, it was clear to me that this kind of technology offered enormous potential for studying schizophrenia, since it could permit us to make quantitative brain measurements using case-control designs. Because it required radiation exposure, however, and because our Insitutional Review Board was convinced that we would not learn anything about schizophrenia by conducting brain measurements, the honor of conducting the first CT study of schizophrenia was captured by the Northwick Park group in England (Johnstone et al., 1976).