Re. Gur et al., A FOLLOW-UP MAGNETIC-RESONANCE-IMAGING STUDY OF SCHIZOPHRENIA - RELATIONSHIP OF NEUROANATOMICAL CHANGES TO CLINICAL AND NEUROBEHAVIORAL MEASURES, Archives of general psychiatry, 55(2), 1998, pp. 145-152
Background: Cross-sectional neuroanatomical studies have reported abno
rmalities in schizophrenia that relate to disease variables. Longitudi
nal neuroimaging investigations that integrate anatomical, clinical, a
nd neurobehavioral measures may help clarify the pathogenesis of schiz
ophrenia. Methods: Magnetic resonance brain imaging and neurobehaviora
l studies were conducted at baseline and after 30.63 +/- 12.92 months
(mean +/- SD) in 40 patients with schizophrenia (23 men and 17 women)
and 17 healthy controls (13 men and 4 women). The schizophrenia group
included 20 first-episode and 20 previously treated subjects. Volumes
of whole-brain, cerebrospinal fluid, and frontal and temporal lobes we
re measured. The severity of negative and positive symptoms was assess
ed, medications were monitored, and neurobehavioral functioning in 8 d
omains was evaluated. Results: Both first-episode and previously treat
ed patients had smaller brains and frontal and temporal lobes than con
trols at intake. Longitudinally, reduction in frontal lobe volume was
found only in patients, whereas temporal lobe reduction was also seen
in controls. The association between volume reduction and symptom chan
ges differed between patient groups, but volume reduction was associat
ed with decline in some neurobehavioral functions in both groups. Expl
oratory analysis suggested that neuroleptic dose is correlated with ch
anges in all 3 domains. Conclusions: The existence of neuroanatomical
and neurobehavioral abnormalities in patients with first episode schiz
ophrenia indicates that the brain dysfunction occurred before clinical
presentation. However, there is also evidence of progression, in whic
h anatomical changes may affect some clinical and neurobehavioral feat
ures of the illness in some patients.