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AJNR - American Journal of Neuroradiology

Published ahead of print on September 26, 2007
doi: 10.3174/ajnr.A0691

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Quantitative Proton MR Spectroscopy Findings in the Corpus Callosum of Patients with Schizophrenia Suggest Callosal Disconnection

K. Aydin^a, A. Ucok^b and S. Cakir^b

^a Department of Neuroradiology, MR Research Unit, stanbul Medical School, stanbul University, Capa, stanbul, Turkey
^b Department of Psychiatry, MR Research Unit, stanbul Medical School, stanbul University, Capa, stanbul, Turkey

View larger version (72K): [in this window] [in a new window]   Fig 1. A and B, MR images showing the MR spectroscopy voxel placement. A, Midline sagittal T2-weighted MR image (TR/TE/NEX, 6790/103 ms/4) of a first-episode patient shows the 1H-MR spectroscopic voxel placement. The maximal anteroposterior length (L) of the corpus callosum is identified (between points a’ and p’). The line drawn perpendicular to the a’p’ line at the anterior one-third point (point t) constitutes the posterior border of posterior genu region (separates the posterior genu from anterior midbody region). The horizontal line (line ac) drawn from the most anterior point of the corpus callosum (point a) to the "crook" of the genu (point c) separates the superior genu above and the inferior genu (open white arrow) below. The 1H-MR spectroscopic voxel (black arrow) is placed into the superior and posterior genu of the corpus callosum. B, Coronal T1-weighted MR image (TR/TE/NEX, 530/30 ms/2) demonstrates the voxel placement into the genu of the corpus callosum.

View larger version (23K): [in this window] [in a new window]   Fig 2. A–D, The proton MR spectra (STEAM, TR = 3.5 seconds) obtained from a first-episode patient with different TE values (TE = 30, 65, 135, and 300 ms, respectively) show the major neurometabolite peaks (NAA at 2.02 ppm, Cr at 3.02 ppm, and Cho at 3.22 ppm).

View larger version (15K): [in this window] [in a new window]   Fig 3. The box-plot graph demonstrates the distribution of NAA concentrations around the median values of all patients (P) and of the control subjects (C). The horizontal lines dividing the boxes represent the median values. The upper and lower edges of the boxes represent the upper and lower quartiles (medians of the upper and lower 50% of the values), respectively. The vertical lines (whiskers) are 1.5 times the inner quartile spread in length, which is measured from the median.

View larger version (12K): [in this window] [in a new window]   Fig 4. A–C, The scatter plots show the relationships between the NAA concentrations (mmol/kg brain) of all patients and the severity of symptoms. The lines between the 95% confidence curves represent linear regression lines. A, The negative correlation between the NAA concentrations and BPRS scores (r = –0.59, P = .001). B, The relationship between the NAA concentrations and severity of negative symptoms (SANS scores) (r = –0.68, P < .001). C, The association (r = –0.41, P = .028) of NAA concentrations with the severity of positive symptoms (SAPS scores).