CLINICAL SUBTYPES OF SCHIZOPHRENIA - DIFFERENCES IN BRAIN AND CSF VOLUME

Objective: Investigations of the relation of clinical features of schi zophrenia to neuroanatomic measures have Produced inconclusive results . The Purpose of this study was to examine measures of whole-brain vol ume in men and women and relate them to clinical subtypes of schizophr enia. Method: Magnetic resonance imaging measures of cranial, brain, a nd ventricular and sulcal CSF volume were examined in 81 patients with schizophrenia (50 men and 31 women), divided into subgroups based on their symptom profiles, and 81 demographically matched healthy compari son subjects. Results: The men had higher cranial and brain volumes th an the women. The patients had smaller cranial and brain volumes than the comparison subjects; they also had higher ventricular CSF volumes and thus higher ventricle-brain ratios (VBRs). Ratio elevations were l arger for the female than for the male schizophrenic Patients. The pat ients with predominantly negative symptoms of schizophrenia had higher VBRs and sulcal CSF-brain ratios than the comparison subjects, althou gh the component volumes did not differ. The patients with predominant ly Schneiderian symptoms had higher VBRs than the comparison subjects but showed reduced cranial and brain volumes. The paranoid patients ha d normal VBRs, reduced sulcal CSF-brain ratios, and lower cranial and sulcal CSF volumes. Conclusions: The results suggest two patterns of n euroanatomic whole-brain abnormalities that differ in severity accordi ng to the relative prominence of negative, Schneiderian, and paranoid symptoms. These patterns may reflect differential involvement of dysge nic and atrophic pathophysiological processes. Sex moderates abnormali ties in the neuroanatomic features of schizophrenia.