SYNOPSIS The MRI scans of 48 schizophrenic patients, fulfilling RDC criteria, were compared to those of 34 healthy controls matched for age, ethnicity and parental social class. The volume of the frontal and anterior parietal lobes was significantly reduced in the schizophrenic group as a result of a selective decrease in cortical volume, with a corresponding increase in the volume of sulcal fluid. Reduction in the volume of the temporal grey matter was more marked on the right, but was not in excess of the loss of volume observed in other areas of the cortex. MRI abnormalities correlated poorly with clinical parameters, although both unemployment and poor pre-morbid adjustment predicted reduced cerebral volume and increased sulcal volume. These results question whether the medial temporal lobes are the only site of structural pathology in schizophrenia.

No abstract

No abstract

The site of lesions responsible for horizontal gaze palsy and various types of internuclear ophthalmoplegia (INO) An outstanding problem in human gaze palsies has been to locate in vivo the paramedian pontine reticular formation (PPRF), which is the immediate pre-motor centre for saccade generation. Although initially defined by animal workers in functional terms as the area of the pontine tegmentum whose damage leads to a gaze palsy, recent single unit recording studies have shown that the PPRF is a conglomerate of various groups of cells with different functions and properties.5 Accordingly, the possibility arises that selective lesions within the PPRF might affect horizontal gaze in different ways. In this paper we will present some evidence supporting this view.With respect to INO, one ofour interests was to determine the cause of slow abduction found in some patients. Conceivably, the slow abduction might be due to an extension of the lesion outside the medial longitudinal fasciculus (MLF) into either the PPRF or the abducens nucleus or fasciculus.6 Alternatively it has been postulated that disordered inhibition of the antagonist medial rectus, also produced by the MLF lesion, slows the abducting movement.7This view, however, assumed that the lesions were confined to the MLF. We have reexamined this question by using the MRI to define the size and/or location of lesions in these two types of INO. Material and methodsThe methodology has been fully described in the companion paper' so that a brief comment will suffice here. The identification of patients with INO and horizontal gaze palsy was made on a clinical basis. Separate eyes DC electrooculography was used to confirm the presence of INO and to distinguish between INOs with normal and slowed abduction, according to the lower limit of abducting velocity in our normal population.6 More information on the patients will be found in the results section of each group.Three separate analyses of the MRI scans were made; (1) identification of the brainstem area where the areas of abnormal MRI signal