Research
Understanding mental illness as a disorder of the brain
His research links tissue, imaging, genetics and clinical trials. The goal is the same as in 1986: understand what goes wrong in the brain and turn that into treatments that truly help people.
Focus areas
Four questions that shape the work.
How schizophrenia arises in the brain
From his first paper on cell loss in the hippocampus to today's hypothesis of disturbed oligodendrocyte maturation: schizophrenia as a disorder of regeneration rather than degeneration.
Exercise as therapy
Can aerobic exercise increase hippocampal volume in schizophrenia and improve memory and daily life? Trials, mechanisms and the question of who benefits.
Early detection, targeted treatment
Imaging, genetics and machine learning are used to predict the course of illness so that patients receive the treatment that suits them.
Mental health care and prevention
Guidelines, health services research and the question of how mental illness can be prevented, including within the German Center for Mental Health.
How the topics shifted
Share of papers per period touching each topic. A paper can cover several topics. Assigned from PubMed titles and keywords.
| Topic | to 1999 | 2000-2004 | 2005-2009 | 2010-2014 | 2015-2019 | 2020-2026 |
|---|---|---|---|---|---|---|
| Neuropathology | 40 % | 29 % | 13 % | 7 % | 10 % | 4 % |
| Neuroimaging | 40 % | 45 % | 29 % | 20 % | 16 % | 15 % |
| Genetics | 13 % | 14 % | 13 % | 24 % | 15 % | 16 % |
| Exercise | 0 % | 4 % | 3 % | 7 % | 13 % | 9 % |
| Brain stimulation | 0 % | 0 % | 7 % | 11 % | 11 % | 4 % |
| Cognition | 15 % | 10 % | 29 % | 20 % | 26 % | 16 % |
| Pharmacotherapy | 6 % | 16 % | 20 % | 16 % | 12 % | 16 % |
| Prediction & AI | 0 % | 0 % | 3 % | 4 % | 10 % | 14 % |
| Care & guidelines | 6 % | 8 % | 8 % | 18 % | 23 % | 24 % |
| COVID-19 | 2 % | 2 % | 0 % | 0 % | 0 % | 7 % |
In detail
Neurobiology of schizophrenia
His doctoral thesis and first paper in 1986 counted neurons in the hippocampus of people with schizophrenia. It became a lifelong question: why does the brain lose volume in this illness without the scarring typical of degeneration? Post-mortem studies, then imaging and stem cell models led him to propose that the maturation of oligodendrocytes, the cells that wrap nerve fibres in myelin, is disturbed.
Papers: 1986, Mol Psychiatry 2003, Schizophr Bull 2023
Aerobic exercise and neuroplasticity
In 2010 his group showed that three months of aerobic exercise increase hippocampal volume in schizophrenia. Multicentre trials followed, along with work on who benefits most and the EPA guidance on physical activity and lifestyle in severe mental illness.
Papers: Arch Gen Psychiatry 2010, Eur Psychiatry 2018, Eur Psychiatry 2024, 2025
Prediction and precision psychiatry
With partners in Munich and across Europe he works on predicting individual courses of illness from imaging, genetic and clinical data, including studies on accelerated brain ageing and reviews of machine learning in psychiatry and clinical psychology.
Guidelines and mental health care
He co-authored international guidelines on the biological treatment of schizophrenia and helped shape the working group that defined treatment resistance in schizophrenia. In Germany he works for better care and prevention, including through the German Center for Mental Health.
Papers: Am J Psychiatry 2016, WFSBP 2012, WFSBP 2026
Projects, consortia and trials
A selection of consortia, infrastructures and trials he leads or contributes to.
German Center for Mental Health (DZPG)
Nationwide network for translational research on prevention, targeted treatment and resilience. Since May 2025 spokesperson of the DZPG together with Silvia Schneider, and spokesperson of the Munich and Augsburg site with its focus on early detection and early intervention.
ESPRIT C3: aerobic exercise in schizophrenia
Multicenter randomized trial within the ESPRIT research network: does aerobic endurance training added to standard care improve cognition and daily functioning? Results published 2023, with follow up analyses on imaging and predictors.
Spironolactone as add-on treatment in schizophrenia
Multicenter trial of a new treatment approach targeting the NRG1-ERBB4 pathway, derived from genetic and neurobiological research.
PsyCourse
Longitudinal cohort on psychotic and affective disorders that links clinical, cognitive, genetic and imaging data over several years. Grew out of DFG Clinical Research Unit 241.
Collaboration
He welcomes collaborations in basic and clinical research, joint grant applications and exchange with partners in health care and industry.