Cortical circuit dysfunction and cognitive deficits in schizophrenia--implications for preemptive interventions.

Schizophrenia is a devastating disorder that is common, usually chronic, frequently associated with substantial co-morbidity for addictive and medical disorders and, as a consequence, very costly in both personal and economic terms. At present, no proven means for preventing or modifying the course of the illness exist. This review discusses evidence supporting the ideas that: (i) impairments in certain cognitive processes are the core feature of schizophrenia; (ii) these cognitive impairments reflect abnormalities in specific cortical circuits; and (iii) these circuitry abnormalities arise during childhood-adolescence. The implications of these findings for the development and implementation of safe, preemptive, disease-modifying interventions in individuals at high risk for a clinical diagnosis of schizophrenia are considered.