Gray matter-changes and correlates of disease severity in schizophrenia: Astatistical parametric mapping study

Voxel-based morphometry has recently been used successfully to detect gray matter volume reductions in schizophrenic patients. The aim of the present study was to confirm the findings on gray-matter changes and to complement these by applying the methodology to CSF-differences. Also, we wanted to de termine whether a correlation exists between a clinically defined parameter of disease severity and brain morphology in schizophrenic patients. We inv estigated 48 schizophrenic patients and compared them with 48 strictly age- and sex-matched controls. High-resolution whole-brain MR-images were segme nted and analyzed using SPM99. In a further analysis, the covariate effect of the global assessment of functioning-score (GAF) was calculated. Main fi ndings were (i) left-dominant frontal, temporal, and insular GM-reductions and (ii) GM-increases in schizophrenic patients in the right basal ganglia and bilaterally in the superior cerebellum; (iii) CSF-space increases in pa tients complementary to some GM-reductions; (iv) a correlation between the GAF-score and local GM-volume in the left inferior frontal and inferior par ietal lobe of schizophrenic patients. This study confirms and extends some earlier findings on GM-reduction and detected distinct GM-increases in schi zophrenic patients. These changes were corroborated by complementary CSF-in creases. Most importantly, a correlation could be established between two p articular gray matter-regions and the overall disease severity, with more s everely ill patients displaying a local GM-deficit. These findings may be o f potentially large importance for both the future interpretation and desig n of neuroimaging studies in schizophrenia and the further elucidation of p ossible pathophysiological processes occurring in this disease. (C) 2001 Ac ademic Press.