Cerebral gray and white matter reductions and clinical correlates in patients with early onset schizophrenia

Few magnetic resonance imaging studies of schizophrenia have investigated b rain tissue volumes and their relation to clinical symptoms in patients wit h an early age at illness onset. The twofold purpose of the study was to in vestigate both gray and white matter volumes in schizophrenic men with an e arly age at illness onset, and to determine whether clinical features corre lated with tissue volume changes, using an automated voxel-by-voxel image a nalysis procedure. Twenty male patients with DSM-IV diagnoses of schizophre nia, and an early age at onset (m +/- SD = 19 +/- 2) were compared with 20 age-matched health men. Magnetic resonance (1.5-T) scans were obtained with an Inversion-Recovery prepared fast gradient echo sequence enhancing gray and white matter contrast. Statistical Parametric Mapping was used for imag e segmentation and comparison. Patients had significant gray matter reducti ons in medial frontal gyri, left insula, left parahippocampus. and left fus iform gyrus; bilateral white matter reductions in frontal lobes, and increa sed total cerebrospinal fluid volume were also observed. Negative symptom s cores were negatively related to white matter volumes in cingulate regions, and in the right internal capsule. These findings emphasize a pattern of l eft-hemisphere gray matter abnormalities, and suggest that fronto-paralimbi c connectivity may be altered in men with early onset schizophrenia. (C) 20 01 Elsevier Science B.V. All rights reserved.