Structural brain abnormalities in chronic schizophrenia at the extremes of the outcome spectrum

Am J Psychiatry. 2001 Jul;158(7):1140-2. doi: 10.1176/appi.ajp.158.7.1140.

Abstract

Objective: This study investigated the relationship between outcome and structural brain abnormalities in schizophrenia.

Method: Intracranial volume and volumes of the cerebrum, gray and white matter, lateral and third ventricles, frontal lobes, thalamus, and cerebellum were measured in 20 patients with a poor outcome, 25 with a favorable outcome, and 23 healthy comparison subjects with magnetic resonance imaging.

Results: Thalamic volume was significantly smaller both in poor-outcome patients and good-outcome patients. In contrast, only poor-outcome patients displayed significantly smaller cerebral gray matter, particularly prefrontal, and enlargement of the lateral and third ventricles. No significant differences were found for intracranial, cerebellar, or cortical CSF volumes.

Conclusions: Smaller thalamic volumes in schizophrenia may reflect a greater susceptibility for the disorder and seem unrelated to outcome. In contrast, gray matter volume loss of the cerebrum, particularly in the frontal lobes, and lateral and third ventricular enlargement appear related to outcome in schizophrenia.

MeSH terms

  • Age of Onset
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / therapeutic use
  • Brain / anatomy & histology*
  • Brain / pathology
  • Cerebral Ventricles / anatomy & histology
  • Cerebral Ventricles / pathology
  • Chronic Disease
  • Frontal Lobe / anatomy & histology
  • Frontal Lobe / pathology
  • Hospitalization
  • Humans
  • Length of Stay
  • Magnetic Resonance Imaging / statistics & numerical data*
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Schizophrenia / diagnosis*
  • Schizophrenia / drug therapy
  • Schizophrenia / pathology
  • Schizophrenic Psychology
  • Thalamus / anatomy & histology
  • Thalamus / pathology
  • Treatment Outcome

Substances

  • Antipsychotic Agents