Cortical sulcal enlargement in catatonic schizophrenia: a planimetric CT study

To determine whether patients with catatonic schizophrenia have specific al terations in brain morphology, internal (ventricles) and external (frontal, temporal, parieto-occipital) components of the cerebrospinal fluid (CSF) s paces were examined morphometrically. Planimetric measurements of computed tomographic (CT) scans from 37 patients with catatonic schizophrenia, 28 pa tients with hebephrenic schizophrenia, and 39 patients with paranoid schizo phrenia, all, diagnosed according to DSM-III-R criteria, were compared with separate age- and sex-matched non-psychiatric control groups, respectively . The areas of the frontal sulci, the parieto-occipital sulci, the inter-he mispheric fissure, and the lateral and third ventricles were measured separ ately for the right and left hemispheres. Catatonic patients showed signifi cant enlargements in almost all CSF spaces, especially in the left fronto-t emporal area which, in addition, correlated significantly with illness dura ton. Hebephrenic patients showed selective enlargements in left temporal an d left/right lower frontal cortical sulci, whereas paranoid schizophrenic p atients showed no enlargements but significant correlations between left te mporal cortical sulcal volume and illness duration. Alterations in temporal cortical areas were present in all three sub-types of schizophrenia. In ad dition to temporal alterations, hebephrenic schizophrenia was characterised by lower frontal (i.e. orbitofrontal) enlargement. Catatonic schizophrenia , the most severe sub-type with regard to clinical symptomatology and brain pathology, showed fronto-parietal cortical alterations. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.