L. Marsh et al., Structural brain abnormalities in patients with schizophrenia, epilepsy, and epilepsy with chronic interictal psychosis, PSYCH RES-N, 108(1), 2001, pp. 1-15
Chronic interictal psychotic syndromes, often resembling schizophrenia, dev
elop in some patients with epilepsy. Although widespread brain abnormalitie
s are recognized as characteristic of schizophrenia, prevailing but controv
ersial hypotheses on the co-occurrence of epilepsy and psychosis implicate
left temporal lobe pathology. In this study, quantitative MRI methods were
used to address the regional specificity of structural brain abnormalities
in patients with epilepsy plus chronic interictal psychosis (E + PSY, n = 9
) relative to three comparison groups: unilateral temporal lobe epilepsy wi
thout chronic psychosis MLE, n = 18), schizophrenia (SCZ, n = 46), and heal
thy control subjects (HC, n = 57). Brain measures, derived from a coronal s
pin-echo MRI sequence, were adjusted for age and cerebral volume. Relative
to HC, all patient groups had ventricular enlargement and smaller temporal
lobe, frontoparietal, and superior temporal gyrus gray matter volumes, with
the extent of these abnormalities greatest in E + PSY. Only TLE had tempor
al lobe white matter deficits, as well as smaller hippocampi, which were ip
silateral to the seizure focus. Structural brain abnormalities in E + PSY a
re not restricted to the left temporal lobe. The confluence of cortical gra
y matter deficits in E + PSY and SCZ suggests salience to chronic psychosis
. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.