Objective-Individuals with 22q11.2 deletion syndrome are known to be at high risk of developing schizophrenia. Previous imaging studies have provided limited data on the relation of schizophrenia expression in 22q11.2 deletion syndrome to specific regional brain volumetric changes. The authors hypothesized that the main structural brain finding associated with schizophrenia expression in 22q11.2 deletion syndrome, as for schizophrenia in the general population, would be gray matter volumetric deficits, especially in the temporal lobes.Method-MR brain images from 29 patients with 22q11.2 deletion syndrome and schizophrenia and 34 comparison subjects with 22q11.2 deletion syndrome and no history of psychosis were analyzed using a voxel-based morphometry method that also yielded volumes for related regionof-interest analyses. The authors compared data from the two groups using an analysis of covariance model correcting for total intracranial volume, age, sex, IQ, and history of congenital cardiac defects. The false discovery rate threshold was set at 0.05 to account for multiple comparisons.Results-Voxel-based morphometry analyses identified significant gray matter reductions in the left superior temporal gyrus (Brodmann's area 22) in the schizophrenia group. There were no significant between-group differences in white matter or CSF volumes. Region-of-interest analyses showed significant bilateral gray matter volume reductions in the temporal lobes and superior temporal gyri in the schizophrenia group.Conclusions-The structural brain expression of schizophrenia associated with the highly penetrant 22q11.2 deletion involves lower gray matter volumes in temporal lobe regions. These structural MRI findings in a 22q11.2 deletion syndrome form of schizophrenia are consistent with those from studies involving schizophrenia samples from the general population. The results provide further support for 22q11.2 deletion syndrome as a genetic subtype and as a useful neurodevelopmental model of schizophrenia.
CIHR Author Manuscript
CIHR Author Manuscript
CIHR Author ManuscriptOf the emerging copy number variations being identified as rare causes of schizophrenia, hemizygous 22q11.2 deletions are the genetic variants with the highest penetrance that convey the greatest elevation of risk for schizophrenia, estimated to be more than 20 times that of the general population (1, 2). Approximately one of every 100 patients with schizophrenia in the general population has a 22q11.2 deletion (3, 4). The associated 22q11.2 deletion syndrome, previously known as velocardiofacial or Di-George syndrome (Mendelian Inheritance of Man #188400, #192430), displays a variable phenotype with common features, including velopharyngeal insufficiency, congenital heart disease, and learning difficulties (5, 6). Mental retardation (IQ <70) is present in a minority of those with the syndrome (5,7,8). The 22q11.2 deletion syndrome has been proposed as a neurodevelopmental model of schizophrenia with enhanced genetic homogeneity that may help us u...