Severity of schizophrenia and magnetic resonance imaging abnormalities: A comparison of state and veterans hospital patients

Background: The relationship between illness severity and neuroanatomical a bnormalities in schizophrenia remains unclear. The purpose of this study wa s to test whether the pattern. and extent of brain volume abnormalities dif fered between two patient groups, distinguished by their overall severity a nd clinical course of schizophrenia, Methods: Subjects were 56 severely ill, chronically hospitalized schizophre nic men from Napa State Hospital (SH-SZ), 44 moderately ill, acutely hospit alized schizophrenic men from the Pale Alto Veterans Administration Health Care System (VA-SZ), and 52 healthy male control subjects. Temporolimbic, v entricular and frontoparietal volumes, quantified from 3-mm coronal spin-ec ho magnetic resonance images and adjusted for cerebral volume and age, were compared using analysis of variance. Results: Compared to control subjects, both SZ groups had smaller (p <.05) temporal lobe and frontoparietal gray matter volumes and larger ventricles and temporal sulci. Whereas SH-SZ had more pronounced cerebrospinal fluid a nd frontoparietal abnormalities relative to VA-SZ; VA-SZ had greater tempor al lobe gray matter deficits. Neither patient group had hippocampal or cere bral volume deficits relative to control subjects. There were no difference s between diagnostic subtypes. Conclusions: The magnitude of volume abnormalities in schizophrenia varies with respect to disease severity and to brain region, but disease severity is not associated with anatomically distinct subgroups. Biol Psychiatry 199 9; 45:49-61 (C) 1999 Society of Biological Psychiatry.