STRUCTURAL EVALUATION OF THE PREFRONTAL CORTEX IN SCHIZOPHRENIA

Objective: Altered prefrontal cortical function has been repeatedly im plicated in the pathophysiology of schizophrenia. Attempts to determin e whether this altered function is associated with structural changes in the prefrontal cortex have been hampered by the failure to examine more anatomically and functionally homogeneous regions. The authors ha ve developed a reliable set of anatomical landmarks for subdividing th e prefrontal cortex into superior, middle, inferior, and orbital regio ns, in order to determine whether patients with schizophrenia exhibit selective morphological abnormalities of the prefrontal cortex. Method : Magnetic resonance imaging (MRI) studies were obtained in 24 normal control subjects (14 men and 10 women) and 18 patients with schizophre nia (12 men and six women) by using a high-resolution thin spoiled-gra dient recall acquisition in the steady-state protocol. The MRI images were used to determine prefrontal gray matter volumes for the four pre frontal regions and prefrontal total gray and white volumes. Results: Patients with schizophrenia exhibited selective gray matter volume red uctions in the right and left inferior prefrontal cortex. There were n o significant group differences in the other prefrontal regions. Patie nts with schizophrenia also exhibited decreased prefrontal total white matter and total volumes; there was no significant difference in pref rontal total gray matter volume. Conclusions: Patients with schizophre nia are characterized by relatively selective reductions in inferior p refrontal cortex gray matter volumes.