Brain and ventricle instability during psychotic episodes of the schizophrenias

Recent reports from serial brain scans suggest that the rate of ventricular expansion and/or brain atrophy may be accelerated in at least some schizop hrenics. The authors assessed the effect of state changes upon such finding s. Within-subject 3D MRIs were assessed for ventricular and brain volumes duri ng periods of [partial] remission and of exacerbation of psychosis, Additio nal scans at comparable within-subject SAPS were used to assess rates of ch ange in volumes that were independent of SAPS changes. Correlations of changes of ventricle and brain volumes vs. change of SAPS c ores between scans revealed that ventricle volumes decreased during a perio d of psychotic exacerbation and increased at a time of [partial] remission (r(p) = -0.666; P < 0.0005); conversely, brain volumes increased during psy chotic exacerbation and decreased at [partial] remission (r(p) = + 0.448; P = 0.032). Scans at comparable SAPS scores suggested that the majority of p atients had rates of ventricular expansion comparable to controls (0.9 +/- 0.6 cc/year), though two patients appeared to have rates of ventricular inc rease of 4.5 +/- 2.1 cc/year (Lilliefores P = 0.036; K-means clustering F = 17.75). Exacerbation of psychosis in schizophrenia is accompanied by evidence of br ain swelling, especially of periventricular brain, with incroachment of bra in substance upon ventricular volumes. Controlled for state changes, the ma jority of schizophrenics show rates of ventricular expansion or brain atrop hy indistinguishable from controls. (C) 2000 Elsevier Science B.V. All righ ts reserved.