Morphological brain abnormalities in schizophrenia determined by computed tomography: A problem of measurement?

doi:10.1016/0165-1781(87)90096-5

Psychiatry Research

Volume 22, Issue 2, October 1987, Pages 91-98

https://doi.org/10.1016/0165-1781(87)90096-5 Get rights and content

Abstract

The size of the cerebral ventricles was estimated from computed tomographic (CT) scans of 14 young patients with schizophrenia and 12 medical controls. The subjects were a representative subsample from a larger sample studied by Boronow et al. (1985). Although no CT abnormalities were detected in the psychiatric patients using traditional measures (mechanical planimetry for the lateral ventricles and a linear measure for the third ventricle), a volumetric analysis of the same 26 scans revealed enlargement of the lateral and third ventricles in the schizophrenics. The effect revealed by volumetric measures of the lateral ventricles was 58% greater than that obtained with digital planimetry and 96% greater than the effect found using mechanical planimetry. No differences were found between volumetric and digital planimetric measures of the third ventricle, but the effect revealed by the latter measure was 114% greater than that obtained by a linear index. It is suggested that volumetric measures of lateral ventricles based on information from several CT slices may be more sensitive to group differences in ventricular size than planimetry. Likewise, area measures of the third ventricle may be more sensitive to group differences than linear measures.

References (15)

E.C. Johnstone et al.
Cerebral ventricular size and cognitive impairment in chronic schizophrenia
Lancet
(1976)
D.R. Weinberger
Computed tomography (CT) findings in schizophrenia: Speculation on the meaning of it all
Journal of Psychiatric Research
(1984)
R.A. Yeo et al.
Volumetric parameters of the human brain: Intellectual correlates
Brain and Cognition
(1987)
S.A. Barron et al.
Changes in size of normal lateral ventricles during aging determined by computerized tomography
Neurology
(1976)
E.R. Bigler et al.
Intellectual and memory impairment in dementia: CT volume correlations
Journal of Nervous and Mental Disease
(1985)
J. Boronow et al.
Atrophy limited to the third ventricle in chronic schizophrenic patients
Archives of General Psychiatry
(1985)
J. Cohen
Statistical Power Analysis for the Behavioral Sciences
(1977)

There are more references available in the full text version of this article.

Cited by (22)

Dopaminergic neuromodulation of semantic priming in a cortical network model
2008, Neuropsychologia
Semantic priming between items stored and associated in memory underlies contextual recall. Response times to process a given target item are shorter when following presentation of a related prime item than when it is unrelated. The study of priming effects allows investigating the structure of semantic networks as a function of association strength and number of links relating the prime and target. Behavioral data from divided visual field experiments in healthy subjects show a variability in the magnitude of priming effects when the left or right hemisphere is primary involved. Data from schizophrenic patients also exhibit variability in priming magnitude compared to data from healthy subjects. Mathematical models of cortical networks allow theorists to understand the link between the physiology of single neurons and synapses and network behavior. Computational modelling can replicate electrophysiological recordings of cortical neurons in monkeys, that exhibit two types of task-related activity, ‘retrospective’ (related to a previously shown stimulus) and ‘prospective’ (related to a stimulus expected to appear, due to learned association between both stimuli). Experimental studies of associative priming report priming effects on behavioral data in both human and monkeys. Cortical network models can account for a large variety of priming effects observed in human, and for the dependence of retrospective activity on dopamine neuromodulation. Here, we investigate how variable levels of dopamine in a model of a cortical network can modulate prospective activity to vary the magnitude of semantic priming. We simulate a biologically realistic network of integrate and fire neurons to study the effects of dopaminergic neuromodulation of NMDA receptors of glutamatergic and gabaergic neurons on semantic priming dynamics. Results support the possibility that different levels of dopaminergic neuromodulation can subtend hemispheric differences in semantic priming, corresponding to focused priming in the left hemisphere and to extended priming in the right hemisphere. Furthermore, results can account for priming perturbations in schizophrenia depending on the level of dopamine.
Ventricular volume and asymmetry in schizotypal personality disorder and schizophrenia assessed with magnetic resonance imaging
1997, Schizophrenia Research
Magnetic resonance imaging (MRI) was performed in 12 patients with schizotypal personality disorder (SPD), 11 patients with chronic schizophrenia, and 23 age-and sex-matched normal volunteers. MRI slices were acquired in the axial plane at 1.2-mm intervals, and the ventricles were traced on every other slice. The lateral ventricular system was divided into the anterior horn, temporal horn, and dorsal lateral ventricle. Schizophrenic patients had larger left anterior and temporal horns than the normal volunteers. Size of the left anterior and temporal horn in SPD patients was intermediate between those of normal volunteers and schizophrenic patients and differed significantly from schizophrenic patients. The left-minus-right difference was larger in schizophrenic patients than in normal volunteers or SPD patients. Thus, in their structural brain characteristics, as well as in their clinical symptomatology, SPD patients evidence, in attenuated form, abnormalities resembling those found in full-fledged schizophrenia. The findings suggest that decreased left hemispheric volume, in frontal and temporal regions, may characterize both psychotic and non-psychotic disorders of the schizophrenia spectrum.
Reliability of in vivo volume measures of hippocampus and other brain structures using MRI
1993, Magnetic Resonance Imaging
Volume reductions of the hippocampus are associated with Alzheimer's disease, schizophrenia, and epilepsy. We used clinically available MRI methods (2D acquisition; inversion recovery and calculated T₂ images; 3 mm contiguous slices) that optimize image contrast, quality, and resolution and standardized positioning protocols to maximize the in vivo accuracy (test-retest reliability) of brain volume measurements in volunteers who were scanned two or three times. Volunteers were scanned in the same MRI instrument (intrascanner reliability) as well as in two different instruments (interscanner reliability). A single rater obtained brain volume measures of seven contiguous slices centered on the anterior commissure. The in vivo intrascanner reliability for measures of anterior hippocampus and ventricular volumes was very good, with reliability coefficients [intraclass r (r_xx)] ranging between .855 and .997, and a median coefficient of variation (CV) of 6.4%. Reliability was good for amygdala (r_xx of .740 and .764) and for total frontal and temporal lobe volumes and white matter volume measures (r_xx ranging between .640 and .823, median coefficient of variation was 3.2%). Overall, interscanner reliability was also good. We discuss the implications of our results relative to the possible clinical utility of hippocampal quantification and the feasibility of prospective studies aimed at quantifying progressive neurodegeneration.
Third-ventricle enlargement and neuropsychological deficit in schizophrenia
1992, Biological Psychiatry
Cerebral ventricular enlargement is present in a substantial subgroup of schizophrenic patients. Most, but not all studies examining neuropsychological performance and ventricular size in schizophrenics show more severe cognitive impairment in those patients with greatest ventricular enlargement. Inconsistencies in this literature have been attributed to different neuroimaging techniques, variation in patient characteristics across studies, and the variety of neuropsychological batteries used.
In the present study, schizophrenic patients (n = 49 men, n = 23 women) and normal controls (n = 13 men, n = 18 women) underwent magnetic resonance (MR) imaging of the brain and extensive neuropsychological testing including measures of frontal and temporal lobe function. A complete coronal set of MR images was used to calculate volumetric estimates of lateral and third cerebral ventricles.
Highly significant associations were found between cognitive deficits and third-ventricle volume, with measures of frontal functioning, attention, and concentration showing the most robust correlations. In contrast, neuropsychological performance was not highly associated with lateral ventricular size.
These findings further support the pathophysiological relevance of ventricular enlargement in schizophrenia. More specifically, third, but not lateral, ventricular enlargement was associated with greater cognitive disturbance in this sample. Results are consistent with pathological involvement of periventricular diencephalic structures resulting in dysfunctional frontal and limbic processing in a subgroup of patients.
The timing of brain morphological changes in schizophrenia and their relationship to clinical outcome
1992, Biological Psychiatry
The present study is an examination of ventricular and temporal lobe size in 50 DSM-III-R first-episode schizophreniform or schizoaffective patients who were ill for less than 6 months. Two-year clinical follow-up and magnetic resonance imaging (MRI) scan analyses are also reported from data collected on an initial group of 30 first-episode schizophrenic patients and controls.
Left ventricular enlargement, which was present in our previously published report of first-episode cases of schizophrenia, is not present to the same extent in this larger group of schizophreniform patients closer to the onset of their illness, and no temporal lobe volume reduction was detected. However, lateral ventricular size at the time of the first-episode was generally correlated with outcome—the larger the ventricles, the poorer the outcome. No mean change in ventricular or temporal lobe size was found at rescanning 2 years later, but the degree of ventricular change was inversely correlated with the number of hospitalizations and the amount of time spent in hospital; it did not correlate with temporal lobe size. When rescanned, some patients showed change greater than 20% in ventricular size and 10% in temporal lobe size. Thus, these findings need further evaluation by serial scans over a longer time period before it can be determined that no progression of brain structural abnormalities is occurring as part of the pathology of schizophrenia, even in a subgroup of patients.
Family history and brain morphology in schizophrenia: An MRI study
1991, Psychiatry Research: Neuroimaging
This study examined neuroanatomical differences between male schizophrenic patients with a family history of psychosis (n = 16) and those without such a history (n = 15). Intracranial area, cerebral area, ventricular size, and cortical atrophy were assessed using magnetic resonance imaging (MRI). Third ventricular enlargement was more prevalent in patients than controls (n = 15). Familial and nonfamilial patients differed significantly. Reduced cranial and cerebral areas without ventricular enlargement characterized familial patients, whereas nonfamilial patients showed marked lateral ventricular enlargement without a reduction in cranial/cerebral size.

View all citing articles on Scopus

^∗: Sarah Raz, M.A., is Ph.D. candidate and Erin D. Bigler, Ph.D., is Associate Professor, Department of Psychology, University of Texas, Austin, TX 78712. Naftali Raz, Ph.D., is Assistant Professor, Department of Psychology, University of Health Sciences/The Chicago Medical School, North Chicago, IL 60064. Daniel R. Weinberger, M.D., is Chief, Neuropsychiatry Branch, NIMH Intramural Research Program, WAW Building, St. Elizabeths Hospital, Washington, DC 20032. John Boronow, M.D., is Senior Psychiatrist, Sheppard-Pratt Hospital, Towson, MD 21204. David Pickar, M.D., is Chief, Section on Clinical Studies, Clinical Neuroscience Branch, National Institute of Mental Health, Building 10, Room 4N214, Bethesda, MD 20205. Eric Turkheimer, Ph.D., is Assistant Professor, Department of Psychology, University of Virginia, Charlottesville, VA 22903.

View full text

Morphological brain abnormalities in schizophrenia determined by computed tomography: A problem of measurement?

Abstract

Lancet

Journal of Psychiatric Research

Brain and Cognition

Changes in size of normal lateral ventricles during aging determined by computerized tomography

Neurology

Intellectual and memory impairment in dementia: CT volume correlations

Journal of Nervous and Mental Disease

Atrophy limited to the third ventricle in chronic schizophrenic patients

Archives of General Psychiatry

Statistical Power Analysis for the Behavioral Sciences