Internal Capsule Size in Good-Outcome and Poor-Outcome Schizophrenia

Abstract

Converging lines of research suggest that white matter abnormalities may be central to the pathophysiology of schizophrenia. The purpose of this study was to examine regional white matter in the anterior limb of the internal capsules in patients with schizophrenia. The authors obtained high-resolution magnetic resonance imaging in 106 patients with schizophrenia and 42 age and sex-matched healthy comparison subjects. The area of the anterior limb of the internal capsule was measured at five proportionately spaced dorsal-to-ventral levels. Schizophrenia patients were divided into good-outcome and poor-outcome groups, based on longitudinal analysis of self-care deficits. Patients with poor-outcome had significantly smaller dorsal areas than healthy comparison subjects, but good-outcome patients did not differ from healthy comparison subjects. Larger relative volumes of the caudate, putamen, and thalamus tended to be associated with relatively larger volumes of the internal capsule in healthy comparison subjects and good-outcome patients, consistent with the known frontal-striatal-thalamic pathways. Larger ventricles were associated with smaller internal capsules, particularly in healthy comparison subjects. The findings suggest disruption of internal capsule fibers in poor-outcome patients with schizophrenia. These abnormalities may be independent of other structural changes in schizophrenia.

MRI Predicts Remission at 1 Year in First-Episode Schizophrenia in Females with Larger Striato-Thalamic Volumes

“…chronically ill or continually hospitalised for 5 years or more [9]. Based on these Kraepelinian samples, posteriorisation of cortical deficits along with smaller posterior cingulate gyrus volume [31] and a smaller anterior limb of the internal capsule [32] have been reported. Although our present study is not directly comparable to the latter, our findings overlap since baseline striato-thalamic volume in our first-episode female patients showed a positive correlation with remission after 1 year.…”

Anterior limb of the internal capsule in schizotypal personality disorder: Fiber-tract counting, volume, and anisotropy

“…who was blind to diagnosis. We employed the same methods as in our earlier study of schizophrenia patients (scanned on a 1.5-Tesla MRI system; Brickman et al, 2006). These tracing methods are described in Figs.…”

“…We previously reported that schizophrenia patients with poor- but not good-outcome show reduced ALIC volume at the most dorsal levels compared with HCs (Brickman et al, 2006). Wobrock et al (2008) reported reduced right ALIC volume in family members with schizophrenia, reduced left ALIC volume in family members without schizophrenia and bilateral reduction in maximal cross sectional area of the ALIC in both groups compared with HCs.…”

Anterior limb of the internal capsule in schizophrenia: a diffusion tensor tractography study

“…Of further note, basal ganglia and thalamo-cortical feedback loops have reciprocal fibers that are projected through the internal capsule from the thalamus to the prefrontal cortex. In recent structural imaging studies, AL-IC volume has also been shown to be decreased in patients with schizophrenia (Brickman, et al, 2006; Lang, et al, 2006; Zhou, et al, 2003). A major concern in the analysis of conventional structural images, however, is that they do not carry information regarding the integrity of the fibers.…”