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Brain abnormality in schizophrenia

A systematic and quantitative review of volumetric magnetic resonance imaging studies

Published online by Cambridge University Press:  02 January 2018

Stephen M. Lawrie  and
Suheib S. Abukmeil
Stephen M. Lawrie*
Affiliation:
Department of Psychiatry, Royal Edinburgh Hospital
Suheib S. Abukmeil
Affiliation:
Department of Psychiatry, Royal Edinburgh Hospital
*
S. M. Lawrie, Department of Psychiatry, Royal Edinburgh Hospital. Edinburgh EH10 5HF. Scotland. Fax 00131 447 6860; e-mail S.Lawrie@ed.ac.uk
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Abstract

Background

Numerous in vivo brain imaging studies suggest that cerebral Structure is abnormal in schizophrenia, but implicate different regions to varying extents.

Method

We identified published MRI studies in schizophrenia with searches of the computerised literature and key Journals. Reports giving the volumes of cortical structures in people with schizophrenia and controls were included. The percentage differences in volumes were calculated and the median taken as a summary measure for each brain region.

Results

Forty relevant studies were identified. The median percentage volume differences revealed overall reductions in the whole brain (3%), temporal lobe (6% left. 9.5% right), and the amygdala/hippocampal complex (6.5%, 5.5%); and increases in the lateral ventricles (44%, 36%), that were greatest in the body and occipital horns. Segmentation studies suggest that grey matter is reduced but that white matter volumes may actually be increased. In men, substantial reductions were also evident in the amygdala and hippocampus, as well as the largest reductions of all in the parahippocampus (14%, 9%). Few studies gave figures for women alone.

Conclusions

Several brain structures in schizophrenia are affected to a greater extent than expected from overall reductions in brain volume. Further studies are required in affected women, and to try to identify clinical and aetiological associations of these findings.

Type
Review Article
Information
The British Journal of Psychiatry , Volume 172 , Issue 2 , February 1998 , pp. 110 - 120
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington. DC: APA.Google Scholar
Andreasen, N. C. Ehrhardt, J. C. Swayze, V. W. et al (1990) Magnetic resonance imaging of the brain in schizophrenia. The pathophysiological significance of structural abnormalities. Archives of General Psychiatry, 47, 35–44.CrossRefGoogle ScholarPubMed
Andreasen, N. C. Fiashman, L. Flaum, M. et al (1994a) Regional brain abnormalities in schizophrenia measured with magnetic resonance imaging. Journal of the American Medical Association, 272, 1763–1769.CrossRefGoogle ScholarPubMed
Andreasen, N. C. Arndt, S. Swayze, V. et al (1994b) Thalamic abnormalities in schizophrenia visualized through magnetic resonance image averaging. Science, 226, 294–298.CrossRefGoogle Scholar
Barta, P. E. Pearlson, G. D. Powers, R. E. et al (1990) Auditory hallucinations and smaller superior temporal gyral volume in schizophrenia. American Journal of Psychiatry, 147, 1457–1462.Google ScholarPubMed
Becker, T. Elmer, K. Mechela, B. et al (1990) MRI findings in medial lobe structures in schizophrenia. European Neuropsychopharmacology, I, 83–86.CrossRefGoogle Scholar
Bilder, R. M. Wu, H. Bogerts, B. et al (1994) Absence of regional hemispheric volumes asymmetries in first-episode schizophrenia. American Journal of Psychiatry, 151, 1437–1447.Google ScholarPubMed
Bogerts, B. Ashtari, M. Degreef, G. et al (1990) Reduced temporal limbic structure volumes on magnetic resonance images in first episode schizophrenia. Psychiatric Research: Neuroimaging, 35, 1–13.CrossRefGoogle ScholarPubMed
Bogerts, B. Lieberman, J. A. Ashtari, M. et al (1993) Hippocampus-amygdala volumes and psychopathology in chronic schizophrenia. Biological Psychiatry, 33, 236–246.CrossRefGoogle ScholarPubMed
Breier, A. Buchanan, R. W. Elkashef, A. et al (1992) A magnetic resonance imaging study of limbic, prefrontal cortex, and caudate structures. Archives of General Psychiatry, 49, 921–926.CrossRefGoogle ScholarPubMed
Chakos, M. H. Lieberman, J. A. Bilder, R. M. et al (1994) Increase in caudate nuclei volumes of first-episode schizophrenic patients taking antipsychotic drugs. American Journal of Psychiatry, 151, 1430–1436.Google ScholarPubMed
Chua, S.E. & McKenna, P. J. (1995) Schizophrenia -a brain disease? A critical review of structural and functional cerebral abnormality in the disorder. British Journal of Psychiatry, 166, 563–582.CrossRefGoogle ScholarPubMed
Dauphinals, D. DeLisi, L. E. Crow, T. J. et al (1990) Reduction in temporal size in siblings with schizophrenia; a magnetic resonance imaging study. Psychiatric Research: Neuroimaging, 35, 137–147.CrossRefGoogle Scholar
Degreef, G. Ashtari, M. Bogerts, B. et al (1992) Volumes of ventricular system subdivisions measured from magnetic resonance images in first-episode schizophrenic patients. Archives of General Psychiatry, 49, 531–537.CrossRefGoogle ScholarPubMed
DeLisi, L. E. Hoff, A. L. Schwartz, J. E. et al (1991) Brain morphology in first-episode schizophrenia-like psychotic patients: a quantitative magnetic resonance imaging study. Biological Psychiatry, 29, 159–175.CrossRefGoogle Scholar
DeLisi, L. E. Stritzke, P. Riordan, H. et al (1992) The timing of brain morphological changes in schizophrenia and their relationship to clinical outcome. Biological Psychiatry, 31, 241–254.CrossRefGoogle ScholarPubMed
DeLisi, L. E. Hoff, A. L. Neale, C. et al (1994) Asymmetries in the superior temporal lobe in male and female first-episode schizophrenic patients: measures of the planum temporale and superior temporal gyrus by MRI. Schizophrenia Research, 12, 19–28.CrossRefGoogle ScholarPubMed
Duvernoy, H. (1991) The Human Brain: Surface. Three-Dimensional Sectional Anatomy and MRI. Vienna: Springer-Verlag.Google Scholar
Flaum, M. Swayze, V. W. O'Leary, D. S. et al (1995) Effects of laterality and gender on brain morphology in schizophrenia. American Journal of Psychiatry, 152, 704–714.Google ScholarPubMed
Frith, C. (1995) Schizophrenia: functional imaging and cognitive abnormalities. Lancet, 346, 615–620.CrossRefGoogle ScholarPubMed
Fukuzako, H. Fukuzako, T. Hashiguchi, T. et al (1996) Reduction in hippocampal formation volume is caused mainly by its shortening in chronic schizophrenia: assessment by MRI. Biological Psychiatry, 39, 938–945.CrossRefGoogle ScholarPubMed
Geddes, J.R. & Lawrie, S. M. (1995) Obstetric complications and schizophrenia: a meta-analysis. British Journal of Psychiatry, 167, 786–793.Google Scholar
Gur, R. E. Mozley, P. D. Resnick, S. M. et al (1991) Magnetic resonance imaging in schizophrenia. Volumetric analysis of brain and cerebrospinal fluid. Archives of General Psychiatry, 48, 407–412.CrossRefGoogle ScholarPubMed
Gur, R. E. Mozley, P. D. Shatsel, D. L. et al (1994) Clinical subtypes of schizophrenia: differences in brain and CSF volume. American Journal of Psychiatry, 151, 343–350.Google ScholarPubMed
Harvey, I. Ron, M. A. Du Boulay, G. et al (1993) Reduction of cortical volume in schizophrenia on magnetic resonance imaging. Psychological Medicine, 23, 591–604.Google Scholar
Jernigan, T. L. Zisooks, S. Heaton, R. K. et al (1991) Magnetic resonance imaging abnormalities in lenticular nuclei and cerebral cortex in schizophrenia. Archives of General Psychiatry, 48, 881–890.CrossRefGoogle ScholarPubMed
Kawasaki, Y. Maeda, Y. Urata, K. et al (1993) A quantitative magnetic resonance imaging study of patients with schizophrenia. European Archives of Psychiatry and Clinical Neurosciences, 242, 268–272.Google Scholar
Kelsoe, J. R. Cadet, J. L. Picard, D. et al (1988) Quantitative neuroanatomy in schizophrenia. Archives of General Psychiatry, 45, 533–541.Google Scholar
Kulynych, J. J. Vladar, K. Jones, D. W. et al (1996) Superior temporal gyrus volume in schizophrenia: a study using MRI morphometry assisted by surface rendering. American Journal of Psychiatry, 153, 50–56.Google ScholarPubMed
Lawrie, S. M. Ingle, G. T. Santosh, C. G. et al (1995) Magnetic resonance imaging and single photon emission tomography in treatment responsive and treatment resistant schizophrenia. British Journal of Psychiatry, 167, 202–210.CrossRefGoogle ScholarPubMed
Lawrie, S. M. Abukmeil, S. Santosh, C. et al (1997) Qualitative morphological abnormalities in schizophrenia: an MRI study and systematic literature review. Schizophrenia Research, 25, 155–166.Google Scholar
Lewis, S. W. (1990) Computerised tomography in schizophrenia: 15 years on. British Journal of Psychiatry, 157 (suppl. 9), 16–24.Google Scholar
Lim, K. O. Sullivan, E. V. Zipursky, R. B. et al (1996) Cortical gray matter volume deficits in schizophrenia: a replication. Schizophrenia Research, 20, 157–164.CrossRefGoogle ScholarPubMed
Marsh, L. Suddath, R. L. Higgins, N. et al (1994) Medial temporal lobe structures in schizophrenia: relationship of size to duration of illness. Schizophrenia Research, II, 225–238.CrossRefGoogle Scholar
Menon, R. R. Barta, P. E. Aylward, E. H. et al (1995) Posterior superior temporal gyrus in schizophrenia: grey matter changes and clinical correlates. Schizophrenia Research, 16, 127–135.CrossRefGoogle ScholarPubMed
Noga, J. T. Aylward, E. Barta, P. E. et al (1995) Cingulate gyrus in schizophrenic patients and normal volunteers. Psychiatry Research: Neuroimaging, 61, 201–208.CrossRefGoogle ScholarPubMed
Nopoulos, P. Torres, I. Flaum, M. et al (1995) Brain morphology in first-episode schizophrenia. American Journal of Psychiatry, 152, 1721–1723.Google Scholar
O'Callaghan, E. Buckley, P. Redmond, O. et al (1992) Abnormalities of cerebral structure in schizophrenia on magnetic resonance imaging: interpretation in relation to the neurodevelopmental hypothesis. Journal of the Royal Society of Medicine, 85, 227–231.Google Scholar
Raz, S. & Raz, N. (1990) Structural brain abnormalities in the major psychoses: a quantitative review of the evidence from computerised imaging. Psychological Bulletin, 108, 93–108.CrossRefGoogle Scholar
Rossi, A. Stratta, P. Mancini, F. et al (1994) Magnetic resonance imaging findings of amygdala-anterior hippocampus shrinkage in male patients with schizophrenia. Psychiatry Research, 52, 43–53.Google Scholar
Schlaepfer, T. E. Harris, G. J. Tien, A. Y. et al (1994) Decreased regional gray matter volume in schizophrenia. American Journal of Psychiatry, 151, 842–848.Google ScholarPubMed
Shenton, M. E. Kikinis, R. McCarley, R. W. et al (1991) Application of automated MRI volumetric measurement techniques to the ventricular system in schizophrenics and normal controls. Schizophrenia Research, 5, 103–113.CrossRefGoogle Scholar
Shenton, M. E. Kikinis, R. Jolesz, F. A. et al (1992) Abnormalities of the left temporal lobe and thought disorder in schizophrenia: a quantitative magnetic resonance imaging study New England Journal of Medicine, 327, 604–612.CrossRefGoogle ScholarPubMed
Suddath, R. L. Casanova, M. F. Goldberg, T. E. et al (1989) Temporal lobe pathology in schizophrenia: a quantitative MRI study. American Journal of Psychiatry, 146, 464–472.Google Scholar
Suddath, R. L. Christison, G. W. Torrey, E. G. et al (1990) Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia. New England Journal of Medicine, 322, 789–794.CrossRefGoogle ScholarPubMed
Swayze, V. W. Andreason, N. C. Alliger, R. J. et al (1992) Subcortical and temporal structures in affective disorder and schizophrenia: a magnetic resonance imaging study Biological Psychiatry, 32, 221–240.CrossRefGoogle Scholar
Turetsky, B. Cowell, P. E. Gur, R. C. et al (1995) Frontal and temporal lobe brain volumes in schizophrenia. Archives of General Psychiatry, 52, 1061–1070.CrossRefGoogle ScholarPubMed
Van Horn, J. D. & McManus, I. C. (1992) Ventricular enlargement in schizophrenia: a meta-analysis of studies of the ventricle: brain ratio (VBR). British Journal of Psychiatry, 160, 687–697.CrossRefGoogle ScholarPubMed
Vita, A. Dieci, M. Giobbio, G. M. et al (1995) Language and thought disorder in schizophrenia: brain morphological correlates. Schizophrenia Research, 15, 243–251.CrossRefGoogle ScholarPubMed
Ward, K. E. Friedman, L. Wise, A. et al (1996) Meta analysis of brain and cranial size in schizophrenia. Schizophrenia Research, 22, 197–213.CrossRefGoogle ScholarPubMed
Wible, C. G. Shenton, M. E. Hokama, H. et al (1995) Prefrontal cortex and schizophrenia. Archives of General Psychiatry, 52, 279–288.CrossRefGoogle ScholarPubMed
Woodruff, P. W. R. McManus, I. C. & David, A. S. (1995) Meta-analysis of corpus callosum size in schizophrenia. Journal of Neurology. Neurosurgery and Psychiatry, 58, 457–461.Google Scholar
Zipursky, R. B. Lim, K. O. Sullivan, E. V. et al (1992) Widespread cerebral grey matter volume deficits in schizophrenia. Archives of General Psychiatry, 49, 195–205.Google Scholar
Zipursky, R. B. Marsh, L. Lim, K. O. et al (1994) Volumetric MRI assessment of temporal lobe structures in schizophrenia. Biological Psychiatry, 35, 501–506.Google Scholar
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