Fine volumetric analysis of the cerebral ventricular system in schizophrenia: Further evidence for multifocal mild to moderate enlargement

We used traditional volumetric regional analysis and a finer anterior-poste rior (AP) profile volumetric analysis to examine the cerebral ventricular s ystem in an all-male, demographically matched sample of schizophrenia patie nts (n = 73) and normal controls (n = 29) using 2.8-mm-thin coronal T-1-wei ghted magnetic resonance images from a 1.5 tesla scanner. Traditional regio nal analysis was performed on various regions using absolute volumes after adjusting for intracranial volume (ICV) and age. The fine AP profile analys is was done by intrasubject "stacking" of contiguous coronal cross-sectiona l volumes (adjusted for ICV and age) across the AP plane, intersubject AP a lignment of all slices relative to the mammillary bodies, and plotting of s lice volumes along the AP plane with 95 percent t-test-based confidence int ervals. Schizophrenia subjects had mild to moderate multifocal ventricular enlargement (overall effect size d = 0.48), which was especially prominent in the right posterior temporal horn and, more generally, in the central to posterior portions of the lateral and third ventricles. Schizophrenia subj ects also had milder enlargement in the left frontal horn, but no significa nt differences were found in the anterior temporal horns and the right fron tal horn. Post hoc analyses of demographic, clinical, and neuropsychologica l variables did not account for much variance in the ventriculomegaly obser ved in the schizophrenia group. The lack of a single locus in the observed ventricular enlargement, the nonsignificant results from schizophrenia subt ypes based on regional distributions, and the strong positive correlations among the ventricular regions for the schizophrenia group suggest that the ventriculomegaly seen in this chronic population reflects a single brainwid e disease process leading to a multifocal or patchy loss of integrity in br ain structure.