Structural brain abnormalities in chronic schizophrenia at the extremes ofthe outcome spectrum

Objective: This study investigated the relationship between outcome and str uctural brain abnormalities in schizophrenia. Method: Intracranial volume and volumes of the cerebrum, gray and white mat ter, lateral and third ventricles, frontal lobes, thalamus, and cerebellum were measured in 20 patients with a poor outcome, 25 with a favorable outco me, and 23 healthy comparison subjects with magnetic resonance imaging. Results: Thalamic volume was significantly smaller both in poor-outcome pat ients and good-outcome patients. In contrast, only poor-outcome patients di splayed significantly smaller cerebral gray matter, particularly prefrontal , and enlargement of the lateral and third ventricles. No significant diffe rences were found for intracranial, cerebellar, or cortical CSF volumes. Conclusions: Smaller thalamic volumes in schizophrenia may reflect a greate r susceptibility for the disorder and seem unrelated to outcome. In contras t, gray matter volume loss of the cerebrum, particularly in the frontal lob es, and lateral and third ventricular enlargement appear related to outcome in schizophrenia.