Computed tomography of the brain in patients with acute psychosis and in healthy volunteers

Abstract

Evidence has been obtained by computed tomography (CT) that some chronic schizophrenic patients have enlarged cerebral ventricles and other brain abnormalities when compared to other patient groups and to healthy controls (Johnstone et al. (1976), Weinberger et al. (1979)). In order to investigate whether structural brain abnormalities can be demonstrated also in younger patients with acute psychosis we have undertaken a CT study in 46 patients and 46 healthy volunteers. Twenty-eight of the patients fulfilled the Research Diagnostic Criteria for schizophrenia. Nineteen had not been hospitalized for psychiatric reasons before. The lateral and third ventricles were significantly wider in the patients than in the volunteers. In the volunteers there was a significant positive correlation between age and size of the lateral ventricles, whereas in the patients, particularly those fulfilling the criteria for schizophrenia, no such correlation was obtained. These results indicate that schizophrenia may be associated with patho-physiological processes which interfere with the normal age-related enlargement of the ventricles. Signs of cortical atrophy, CSF circulation disturbances and reversed asymmetry of the occipital lobes were more frequent in the patient group then among the controls. These results are in accordance with previously published findings and indicate that structural brain abnormalities can be found in relatively young patients with acute psychosis.

Normal ventricles in chronic schizophrenics

“…Regarding subtypes, the paranoid and nonparanoidhebephrenic groups had significantly larger ventricles than the nonparanoidundifferentiated group. Nyback et al (10) studied acute psychoses and found sig-nificantly larger ventricles both in the whole sample and in the schizophrenic group as compared with the controls. Okasha et al (11) reported highly significant differences in central atrophy between chronic schizophrenics and controls.…”

Abnormal Functional and Structural Asymmetry as Biomarker for Schizophrenia

“…The existing studies show, on the one hand, a reversal of the normal asymmetry in patients with schizophrenia [219], and on the other hand a reversal of asymmetry in the occipital but not in the frontal lobe [220][221][222]. Others did not find any differences in comparison with controls [223][224][225][226][227]. Also, a reduction or absence of normal torque (i.e., the right frontal and left occipital petalias was reported frequently [228][229].…”

Postmortem Evidence of Structural Brain Changes in Schizophrenia

“…(Arch Gen Psychiatry 1986;43: [36][37][38][39][40][41][42] A lthough Kraepelin1 stated boldly in 1907 that in demen-. tia praecox (later to be called schizophrenia) "the fact is decisive that the morbid anatomy has disclosed not simple inadequacy of the nervous constitution but destructive morbid processes as the background of the clinical picture," subsequent neuropathological studies have not given this statement unequivocal support.…”