A serial longitudinal quantitative MRI study of cerebral changes in first-episode schizophrenia using image segmentation and subvoxel registration

Lateral ventricular enlargement is the most consistently replicated brain a bnormality found in schizophrenia. This article reports a first episode, lo ngitudinal study of ventricular volume using high-resolution serial magneti c resonance imaging (MRI) and recently developed techniques for image regis tration and quantitation. Baseline and follow-up ton average X months later ) MRI scans were carried out on 24 patients and 12 controls. Accurate subvo xel registration was performed and subtraction images were produced to reve al areas of regional brain change. Whereas there were no differences betwee n patients and controls with respect to the mean change in ventricular volu me, the patients were much more variable in this respect and showed larger increases and decreases. The percentage increase in ventricular size was gr eater than one standard deviation of control values for 14 patients and the percentage decrease exceeded one standard deviation in eight patients. Alt hough the finding of progressive ventricular enlargement in a proportion of patients supports other studies indicating an ongoing neuropathological pr ocess in the early stages of schizophrenia, the reduction of ventricular si ze in the remaining patients is more difficult To explain. It is suggested that this may reflect improvement in nutrition and hydration following trea tment. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.