Cavum septi pellucidi in first-episode schizophrenia and first-episode affective psychosis: an MRI study

Abstract

A high prevalence of abnormal cavum septi pellucidi (CSP) in schizophrenia may reflect neurodevelopmental abnormalities in midline structures of the brain. The relationship, however, between abnormal CSP and clinical symptoms, and with abnormalities in other limbic structures remains unclear, as does the question of whether a similar abnormality is present in affective psychosis. Seventy-four patients at their first hospitalization, 33 with schizophrenia and 41 with affective (mainly manic) psychosis, and 56 healthy control subjects underwent high-spatialresolution magnetic resonance imaging (MRI). CSP on six slices or more on 0.9375-mm resampled coronal images was categorized as abnormal. The prevalence of abnormal CSP in both schizophrenic patients (26.1%) and affective psychosis patients (18.2%) was significantly higher than was observed in control subjects (8.2%). In schizophrenic patients only, larger CSP was significantly associated with more severe thinking disturbance and smaller left parahippocampal gyrus gray matter volumes. While the relationships between CSP ratings and clinical symptoms did not significantly differ between the two psychosis groups as assessed by the comparison of regression slopes, the association with limbic volumes appeared to be specific to schizophrenic patients. These results suggest that psychosis associated with schizophrenia and affective disorder share, at least to some extent, neurodevelopmental abnormalities involving midline structures and associated psychopathological consequences. However, the association between abnormal CSP and limbic systems may be more specific to schizophrenia.

MRI abnormalities of the hippocampus and cavum septi pellucidi in females with schizotypal personality disorder

“…Nonetheless, the neurodevelopmental abnormalities which are manifest by having a larger CSP may be clinically important for SPD subjects, as suggested by the correlation between the clinical criteria of impairment due to odd speech and number of MRI slices containing a CSP in SPD subjects. Indeed, in schizophrenia, a larger CSP was correlated with thinking disturbances (Kasai et al, 2004), similar to what was shown here.…”

“…Such developmental and genetic factors may help explain why there were negative correlations between large CSP and hippocampal volumes (Kwon et al, 1998) and parahippocampal volumes (Kasai et al, 2004) in schizophrenia, but not in SPD. Nonetheless, the neurodevelopmental abnormalities which are manifest by having a larger CSP may be clinically important for SPD subjects, as suggested by the correlation between the clinical criteria of impairment due to odd speech and number of MRI slices containing a CSP in SPD subjects.…”

“…Moreover, it has been hypothesized that the delusions experienced by paranoid schizophrenics may be linked to hyperactivity of the dopamine-sensitive CA1 region neurons (Krieckhaus et al, 1992). With respect to the CSP, larger CSP have been associated with abnormalities in the verbal domain, specifically, with lower verbal IQ scores (Nopoulos et al, 2000); with the thinking disturbance factor from the BPRS (Kasai et al, 2004); and with poorer prognosis as measured by years of hospitalization (Fukuzako and Kodama, 1998).…”

Cavum Septum Pellucidum and Cavum Vergae With Late-Onset Catatonia

“…Complete non-fusion of the two laminae of the septum pellucidum, a phenomenon termed combined CSP and CV, is the most extreme form of CSP. Associations between large CSP and functional psychosis disorders, especially schizophrenia, have been reported [1][2][3][4][5]. We present an unusual case of late-onset catatonia with CSP and CV.…”

“…During development, a space exists between the laminae, called the cavum septum pellucidum (CSP); this is filled with cerebrospinal fluid and usually disappears during infancy. However, CSP occasionally persists and may be associated with neurodevelopmental abnormalities of midline and limbic structures [1][2][3]. The cavum vergae (CV) is a normal variant of the septum pellucidum in which there is separation of the laminae with posterior extension to the splenium of the corpus callosum.…”