Studies of the postmortem human brain have become an increasingly essential element of the effort to understand the neurobiology of psychiatric disorders, especially in light of advances in our knowledge of functional brain circuitry and the new opportunities to apply the approaches of genomics and proteomics. This Perspective reviews some of the opportunities afforded by investigations of the postmortem human brain, and offers suggestions for improving the quality of future studies through the use of wellcharacterized brain specimens, well-constructed experimental designs and well-controlled confounds. [Neuropsychopharmacology 26:143-154, 2002] © 2002 American College of Neuropsychopharmacology. Published by Elsevier Science Inc.
KEY WORDS : Brain banks; Clinical diagnosis; Postmortem interval; SchizophreniaResearch into the pathophysiological mechanisms operative in a number of psychiatric disorders, and the insights that those findings provide regarding pathogenetic factors and treatment approaches, have been greatly accelerated in recent years through the increasing temporal, spatial and neurochemical resolution of in vivo neuroimaging techniques. In addition, genetic and behavioral animal models have provided tractable systems for investigating the details of plausible pathophysiological mechanisms. However, neither in vivo neuroimaging nor animal models permit the direct investigation of the diseased brain tissue.Although disparaged in the past due to the limitations imposed by confounding variables and the lack of reproducible findings (Plum 1972), the use of postmortem human brain specimens in the study of psychiatric disorders has experienced new life in the past 15 years. The current interest in such studies may be traced to the confluence of several streams of thought. The first, and perhaps most critical, influence was the growing recognition in the 1960s and 1970s that major psychiatric disorders are diseases of the brain, and that at least some disorders, such as schizophrenia, are associated with altered brain anatomy (Stevens 1973;Johnstone et al. 1976). Second, the pioneering investigations, principally of schizophrenia, initiated in the 1980s by Francine Benes, Joel Kleinman, Arnold Scheibel and others, began to demonstrate that postmortem studies could incorporate the types of experimental designs and controls for potential confounds that characterized other areas of empirical study. Finally, the broad advances in our fund of knowledge in neuroscience, coupled with the development of new methods that could be applied in studies of postmortem brain tissue, created opportunities for novel and powerful probings into the pathobiology of psychiatric disorders. Indeed, based on the current demands for access to postmortem human brain specimens, the interest in these types of investigations of psychiatric disorders has never been greater. 26 , NO . 2 The direct study of the postmortem human brain provides several essential elements in the study of psychiatric disorders that are not currently, an...