Tucked into a corner of the basement level of Columbia University’s Neurological Institute, scientists are exploring some of the last unchartered territory on the planet: the human brain.

It’s here that researchers made a recent breakthrough. A study published in the September 2009 Archives of General Psychiatry reported that doctors may be able to diagnose early-stage schizophrenia using a functional magnetic resonance imaging (fMRI) brain scan.

The test, given to patients who show early warning signs of developing the mental illness, could allow doctors to treat schizophrenia before symptoms begin and to develop better medication for the illness. Some psychiatrists warn that change on the clinical level for patients is still a long way away, but advocates for the mentally ill see this as a breakthrough in treatment and attitudes toward mental illness.

“Mental illness is an illness like any other,” said Wendy Brennan, executive director of the National Alliance on Mental Illness’s New York City Metro office. “It has a physiological component to it. It’s no one’s fault.”

The National Institute of Mental Health defines schizophrenia as a chronic brain disorder where a person loses touch with reality and experiences hallucinations or delusions. The institute estimates 2.4 million Americans suffer from the illness. In New York City, 1 percent of the population – or as many as 82,000 people – is afflicted, said Brennan. She said studies like the one published in the Archives of General Psychiatry are important to show the physiological side of mental disorders. Brennan blamed the stigma against mental illness for preventing people from seeking quality treatment and services. She said people would be better served if schizophrenia and other mental illnesses were seen in the same light as heart disease: chronic conditions that can be diagnosed and treated through medication.

Dr. Scott Schobel, assistant professor of clinical psychiatry at Columbia and the New York State Psychiatric Institute and first author of the study, used the same analogy. During the study, researchers discovered that participants who were at high-risk for developing schizophrenia showed hyperactivity in a subregion of the hippocampus known as the CA1 subfield. Schobel said the brain scan could be used to look for hyperactivity in the CA1 region as an indicator of schizophrenia the way a cholesterol test is used as an indicator of heart disease.

But Dr. Wes Dickerson, an attending physician at Kings County Hospital’s Behavioral Health Department in Brooklyn, is skeptical about how the study will help patients.

“Does this change clinical management?” he said. “It puts us a few steps closer to understanding schizophrenia, but it’s too early to say if it will affect my day to day clinical practice.”

By the time most patients reach Dickerson – either brought in by family, the police, or an ambulance – the point for early-stage testing has passed. Instead, he and the doctors in his group rely on clinical symptoms for diagnosis. “In psychiatry, we’re not dealing with a yes or no answer,” he said. “We’re dealing with a spectrum.”

Yet he acknowledged that each new study leads to a better understanding of the brain, which remains mostly uncharted. “It’s still the wild west of medicine,” he said.

For the findings to be used clinically, Schobel said the research would have to be replicated using a greater test sample. The study conducted at the Neurological Institute involved 18 young adults identified as high-risk for developing schizophrenia because of genetic – a sibling or parent with the disorder – or clinical factors.  Most were referred by guidance counselors or social workers. Researchers followed the subjects for two years. Of the participants who showed hyperactivity in the CA1 subfield, 70 percent went on to develop full-blown schizophrenia.

On the National Alliance on Mental Illness’s New York City Metro Web site, a link directs people to mental health studies looking for participants. While the group does not promote particular interests, Brennan said it is important that research go on. “The more we understand the way the brain works physiologically and biologically, the better outcomes there will be.”

For now, scientists continue to tackle this final frontier in modern medicine.