Computerised Tomography in Schizophrenia 15 Years On

Lewis, Shôn

doi:10.1192/s0007125000291824

Cited by 153 publications

(48 citation statements)

References 96 publications

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“…One of the first observations in early imaging studies in SZ was evidence of larger ventricles, although again as with other variables the effect size seems to have diminished with time as Lewis has previously observed[4]. …”

Section: Discussionmentioning

confidence: 69%

Brain size and brain/intracranial volume ratio in major mental illness

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Collins

et al. 2010

BMC Psychiatry

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BackgroundThis paper summarizes the findings of a long term study addressing the question of how several brain volume measure are related to three major mental illnesses in a Colorado subject group. It reports results obtained from a large N, collected and analyzed by the same laboratory over a multiyear period, with visually guided MRI segmentation being the primary initial analytic tool.MethodsIntracerebral volume (ICV), total brain volume (TBV), ventricular volume (VV), ventricular/brain ratio (VBR), and TBV/ICV ratios were calculated from a total of 224 subject MRIs collected over a period of 13 years. Subject groups included controls (C, N = 89), and patients with schizophrenia (SZ, N = 58), bipolar disorder (BD, N = 51), and schizoaffective disorder (SAD, N = 26).ResultsICV, TBV, and VV measures compared favorably with values obtained by other research groups, but in this study did not differ significantly between groups. TBV/ICV ratios were significantly decreased, and VBR increased, in the SZ and BD groups compared to the C group. The SAD group did not differ from C on any measure.ConclusionsIn this study TBV/ICV and VBR ratios separated SZ and BD patients from controls. Of interest however, SAD patients did not differ from controls on these measures. The findings suggest that the gross measure of TBV may not reliably differ in the major mental illnesses to a degree useful in diagnosis, likely due to the intrinsic variability of the measures in question; the differences in VBR appear more robust across studies. Differences in some of these findings compared to earlier reports from several laboratories finding significant differences between groups in VV and TBV may relate to phenomenological drift, differences in analytic techniques, and possibly the "file drawer problem".

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Section: Discussionmentioning

confidence: 69%

Brain size and brain/intracranial volume ratio in major mental illness

Reite

Collins

et al. 2010

BMC Psychiatry

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“…Clinical reports suggested cortical atrophy only in three patients, where it was mild, and comparison against a database of schizophrenic CT scans indicated that all the patients fell within the range of modest lateral ventricular enlargement and cortical sulcal widening seen in the disorder as a whole 6970 In general, CT70 and MRI71 studies have not yielded consistent evidence for a relation between cognitive impairment and structural abnormality in schizophrenia. One study72 found that age disoriented patients had lateral ventricles which were significantly larger than those who were age oriented.…”

Section: Discussionmentioning

confidence: 93%

Dementia as a complication of schizophrenia

Vries

Honer²,

Kemp³

et al. 2001

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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Objectives-Cognitive impairment is known to occur in schizophrenia, and may be marked in institutionalised patients. The aim of this study was to determine whether it ever warrants an additional diagnosis of dementia. Methods-A population of chronic schizophrenic patients who were aged 65 or younger and showed no organic risk factors for dementia were screened for presence of disorientation. Any showing this underwent neuropsychological testing, physical investigations, and structural and functional neuroimaging. Information about day to day cognitive function was also obtained from carers. Results-Eight patients aged 28 to 64 were identified who showed disorientation; in all cases this was accompanied by general intellectual impairment and objective evidence of a dementia syndrome. The patients' schizophrenic symptoms were unexceptional and did not seem suYcient to account for their cognitive impairment. Neuropsychological testing disclosed relative sparing of visual and visuospatial function and language syntax, but pervasive deficits in memory and executive function. Brain CT demonstrated only minor abnormalities but most of the patients showed frontal or temporal hypoperfusion on SPECT. Conclusions-Dementia in schizophrenia seems to be a real entity with a neuropsychological signature similar to that of frontotemporal dementia. Functional but not structural imaging abnormalities may also be characteristic. (J Neurol Neurosurg Psychiatry 2001;70:588-596)

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“…Another larger study, however, found no relationship -or rather a complex relationship with an excess of cognitively impaired patients at both ends of distribution of lateral ventricular size (Owens et al 1985). When Lewis (1990) reviewed the literature on this point he came to the conclusion that the association had more positive than negative replications, but that the nature and extent of the impairment tended to vary from study to study. At present, no findings exist relating general cognitive impairment in schizophrenia to functional imaging.…”

Section: Overall Intellectual Deterioration In Schizophreniamentioning

confidence: 97%