A review of MRI findings in schizophrenia

Abstract

After more than 100 years of research, the neuropathology of schizophrenia remains unknown and this is despite the fact that both Kraepelin (1919/1971: Kraepelin,E., 1919/1971. Dementia praecox. Churchill Livingston Inc., New York) and Bleuler (1911/1950: Bleuler, E., 1911/1950. Dementia praecox or the group of schizophrenias. International Universities Press, New York), who first described 'dementia praecox' and the ' schizophrenias', were convinced that schizophrenia would ultimately be linked to an organic brain disorder. Alzheimer (1897: Alzheimer, A., 1897. Beitrage zur pathologischen anatomie der hirnrinde und zur anatomischen grundlage einiger psychosen. Monatsschrift fur Psychiarie und Neurologie. 2, 82-120) was the first to investigate the neuropathology of schizophrenia, though he went on to study more tractable brain diseases. The results of subsequent neuropathological studies were disappointing because of conflicting findings. Research interest thus waned and did not flourish again until 1976, following the pivotal computer assisted tomography (CT) finding of lateral ventricular enlargement in schizophrenia by Johnstone and colleagues. Since that time significant progress has been made in brain imaging, particularly with the advent of magnetic resonance imaging (MRI), beginning with the first MRI study of schizophrenia by Smith and coworkers in 1984 (Smith, R.C., Calderon, M., Ravichandran, G. K., et al. (1984). Nuclear magnetic resonance in schizophrenia: A preliminary study. Psychiatry Res. 12, 137-147). MR in vivo imaging of the brain now confirms brain abnormalities in schizophrenia.The 193 peer reviewed MRI studies reported in the current review span the period from 1988 to August, 2000. This 12 year period has witnessed a burgeoning of MRI studies and has led to more definitive findings of brain abnormalities in schizophrenia than any other time period in the history of schizophrenia research. Such progress in defining the neuropathology of schizophrenia is largely due to advances in in vivo MRI techniques. These advances have now led to the identification of a number of brain abnormalities in schizophrenia. Some of these abnormalities confirm earlier postmortem findings, and most are small and subtle, rather than large, thus necessitating more advanced and accurate measurement tools. These findings include ventricular enlargement (80% of studies reviewed) and third ventricle enlargement (73% of studies reviewed). There is also preferential involvement of medial temporal lobe structures (74% of studies reviewed), which include the amygdala, hippocampus, and parahippocampal gyrus, and neocortical temporal lobe regions (superior temporal gyrus) (100% of studies reviewed). When gray and white matter of superior temporal gyrus was combined, 67% of studies reported abnormalities. There was also moderate evidence for frontal lobe abnormalities (59% of studies reviewed), particularly prefrontal gray matter and orbitofrontal regions. Similarly, there was moderate evidence for parietal lobe ab...

MR connectomics: Principles and challenges

“…In addition the neuro-science community is becoming increasingly aware that mis-or dis-connectivity is implicated not only in the etiology of many neuro-psychiatric diseases but also as the primary mechanism for observed morphometric changes (Kyriakopoulos et al, 2008;Shenton et al, 2001;Thompson and Apostolova, 2007). Schizophrenia and Alzheimer's disease are the two most prominent examples (Bassett et al, 2008;Buckner et al, 2009).…”

Age-related deficits in fronto-temporal connections in schizophrenia: A diffusion tensor imaging study

“…Over the past two decades, structural MRI studies have been successful in delineating frontotemporal gray matter abnormalities in schizophrenia (Shenton et al, 2001), further suggesting an impairment in connectivity between these brain regions. Moreover, connections between gray matter regions provided by white matter tracts are an important new area to investigate.…”

“…Many brain abnormalities are observed when a patient first becomes symptomatic (Shenton et al, 2001), but it is still not known whether brain abnormalities observed early in the course of illness are more "static", and seemingly more trait like, or if they are more "dynamic", where progressive changes may dominate. Studies in first episode schizophrenia (Price et al, 2005;Szeszko et al, 2005) have shown less pronounced FA abnormalities than chronic schizophrenia studies.…”

Planum Temporale and Heschl Gyrus Volume Reduction in Schizophrenia: A Magnetic Resonance Imaging Study of First-Episode Patients

“…[1][2][3][4][5] Several studies have reported abnormalities in portions of the superior temporal gyrus (STG) in patients diagnosed as having schizophrenia, [1][2][3] including planum temporale (PT) and Heschl gyrus (HG) (primary auditory cortex). [6][7][8][9][10][11][12][13][14] The impetus for much of this work is based on the role that the left (dominant) hemisphere PT plays in language processing [15][16][17] and the role that the HG plays in the initial processing of auditory information.…”

“…[6][7][8][9][10][11][12][13][14] The impetus for much of this work is based on the role that the left (dominant) hemisphere PT plays in language processing [15][16][17] and the role that the HG plays in the initial processing of auditory information. [1][2][3] DeLisi et al 10 measured length of the sylvian fissure and reported asymmetry differences in patients with first-episode schizophrenia compared with controls. Reduced cortical PT volume was reported in a postmortem study in schizophrenia compared with controls, 18 and we reported reduced left PT gray matter volume and a reversal of PT asymmetry in patients diagnosed as having chronic schizophrenia.…”