Structural brain abnormalities in patients with schizophrenia, epilepsy, and epilepsy with chronic interictal psychosis

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.