REGIONAL BRAIN ABNORMALITIES IN SCHIZOPHRENIA MEASURED WITH MAGNETIC-RESONANCE-IMAGING

Objective.-To determine general and regional indices of structural bra in abnormality in schizophrenia. Design.-Case-control comparison study . Subjects.-Fifty-two patients diagnosed as having schizophrenia accor ding to the criteria of the Diagnostic and Statistical Manual of Menta l Disorders, Revised Third Edition, were compared with 90 healthy volu nteers recruited from the community. Measurements.-Structural brain im ages were acquired using magnetic resonance; measurements were obtaine d using three-dimensional visualization of volume-rendered brains and an automated atlas-based dissection of specific regions. General measu res included the volume of total brain tissue, total cerebrospinal flu id (CSF), and CSF within the ventricular system. Regional measures inc luded the volume of tissue and CSF in the frontal; temporal, parietal, and occipital lobes and the cerebellum. Results.-Compared with the co ntrols, the patients had a smaller average volume of total brain tissu e and a greater average volume of total and ventricular CSF. A specifi c relative decrease in brain tissue was found only in the frontal lobe s, although the volume of CSF was greater in patients than in controls in all brain regions. Conclusion.-In addition to the generalized brai n abnormalities observed in schizophrenia, a regional abnormality may be present in frontal regions. Since the frontal lobes integrate multi modality information and perform a variety of ''higher'' cognitive and emotional functions that are impaired in schizophrenia, the frontal a bnormality noted is consistent with the clinical presentation of the i llness. Impaired frontal function and a disruption in its complex circ uitry (including thalamocortical projections) may explain why patients with schizophrenia often have significant deficits in formulating con cepts and organizing their thinking and behavior.