Skip to main content
×
×
Home

Brain abnormality in schizophrenia: A systematic and quantitative review of volumetric magnetic resonance imaging studies

  • Stephen M. Lawrie (a1) and Suheib S. Abukmeil (a1)
Abstract
Background

Numerous in vivo brain imaging studies suggest that cerebral Structure is abnormal in schizophrenia, but implicate different regions to varying extents.

Method

We identified published MRI studies in schizophrenia with searches of the computerised literature and key Journals. Reports giving the volumes of cortical structures in people with schizophrenia and controls were included. The percentage differences in volumes were calculated and the median taken as a summary measure for each brain region.

Results

Forty relevant studies were identified. The median percentage volume differences revealed overall reductions in the whole brain (3%), temporal lobe (6% left. 9.5% right), and the amygdala/hippocampal complex (6.5%, 5.5%); and increases in the lateral ventricles (44%, 36%), that were greatest in the body and occipital horns. Segmentation studies suggest that grey matter is reduced but that white matter volumes may actually be increased. In men, substantial reductions were also evident in the amygdala and hippocampus, as well as the largest reductions of all in the parahippocampus (14%, 9%). Few studies gave figures for women alone.

Conclusions

Several brain structures in schizophrenia are affected to a greater extent than expected from overall reductions in brain volume. Further studies are required in affected women, and to try to identify clinical and aetiological associations of these findings.

Copyright
Corresponding author
S. M. Lawrie, Department of Psychiatry, Royal Edinburgh Hospital. Edinburgh EH10 5HF. Scotland. Fax 00131 447 6860; e-mail S.Lawrie@ed.ac.uk
References
Hide All
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington. DC: APA.
Andreasen, N. C. Ehrhardt, J. C. Swayze, V. W. et al (1990) Magnetic resonance imaging of the brain in schizophrenia. The pathophysiological significance of structural abnormalities. Archives of General Psychiatry, 47, 3544.
Andreasen, N. C. Fiashman, L. Flaum, M. et al (1994a) Regional brain abnormalities in schizophrenia measured with magnetic resonance imaging. Journal of the American Medical Association, 272, 17631769.
Andreasen, N. C. Arndt, S. Swayze, V. et al (1994b) Thalamic abnormalities in schizophrenia visualized through magnetic resonance image averaging. Science, 226, 294298.
Barta, P. E. Pearlson, G. D. Powers, R. E. et al (1990) Auditory hallucinations and smaller superior temporal gyral volume in schizophrenia. American Journal of Psychiatry, 147, 14571462.
Becker, T. Elmer, K. Mechela, B. et al (1990) MRI findings in medial lobe structures in schizophrenia. European Neuropsychopharmacology, I, 8386.
Bilder, R. M. Wu, H. Bogerts, B. et al (1994) Absence of regional hemispheric volumes asymmetries in first-episode schizophrenia. American Journal of Psychiatry, 151, 14371447.
Bogerts, B. Ashtari, M. Degreef, G. et al (1990) Reduced temporal limbic structure volumes on magnetic resonance images in first episode schizophrenia. Psychiatric Research: Neuroimaging, 35, 113.
Bogerts, B. Lieberman, J. A. Ashtari, M. et al (1993) Hippocampus-amygdala volumes and psychopathology in chronic schizophrenia. Biological Psychiatry, 33, 236246.
Breier, A. Buchanan, R. W. Elkashef, A. et al (1992) A magnetic resonance imaging study of limbic, prefrontal cortex, and caudate structures. Archives of General Psychiatry, 49, 921926.
Chakos, M. H. Lieberman, J. A. Bilder, R. M. et al (1994) Increase in caudate nuclei volumes of first-episode schizophrenic patients taking antipsychotic drugs. American Journal of Psychiatry, 151, 14301436.
Chua, S.E. & McKenna, P. J. (1995) Schizophrenia -a brain disease? A critical review of structural and functional cerebral abnormality in the disorder. British Journal of Psychiatry, 166, 563582.
Dauphinals, D. DeLisi, L. E. Crow, T. J. et al (1990) Reduction in temporal size in siblings with schizophrenia; a magnetic resonance imaging study. Psychiatric Research: Neuroimaging, 35, 137147.
Degreef, G. Ashtari, M. Bogerts, B. et al (1992) Volumes of ventricular system subdivisions measured from magnetic resonance images in first-episode schizophrenic patients. Archives of General Psychiatry, 49, 531537.
DeLisi, L. E. Hoff, A. L. Schwartz, J. E. et al (1991) Brain morphology in first-episode schizophrenia-like psychotic patients: a quantitative magnetic resonance imaging study. Biological Psychiatry, 29, 159175.
DeLisi, L. E. Stritzke, P. Riordan, H. et al (1992) The timing of brain morphological changes in schizophrenia and their relationship to clinical outcome. Biological Psychiatry, 31, 241254.
DeLisi, L. E. Hoff, A. L. Neale, C. et al (1994) Asymmetries in the superior temporal lobe in male and female first-episode schizophrenic patients: measures of the planum temporale and superior temporal gyrus by MRI. Schizophrenia Research, 12, 1928.
Duvernoy, H. (1991) The Human Brain: Surface. Three-Dimensional Sectional Anatomy and MRI. Vienna: Springer-Verlag.
Flaum, M. Swayze, V. W. O'Leary, D. S. et al (1995) Effects of laterality and gender on brain morphology in schizophrenia. American Journal of Psychiatry, 152, 704714.
Frith, C. (1995) Schizophrenia: functional imaging and cognitive abnormalities. Lancet, 346, 615620.
Fukuzako, H. Fukuzako, T. Hashiguchi, T. et al (1996) Reduction in hippocampal formation volume is caused mainly by its shortening in chronic schizophrenia: assessment by MRI. Biological Psychiatry, 39, 938945.
Geddes, J.R. & Lawrie, S. M. (1995) Obstetric complications and schizophrenia: a meta-analysis. British Journal of Psychiatry, 167, 786793.
Gur, R. E. Mozley, P. D. Resnick, S. M. et al (1991) Magnetic resonance imaging in schizophrenia. Volumetric analysis of brain and cerebrospinal fluid. Archives of General Psychiatry, 48, 407412.
Gur, R. E. Mozley, P. D. Shatsel, D. L. et al (1994) Clinical subtypes of schizophrenia: differences in brain and CSF volume. American Journal of Psychiatry, 151, 343350.
Harvey, I. Ron, M. A. Du Boulay, G. et al (1993) Reduction of cortical volume in schizophrenia on magnetic resonance imaging. Psychological Medicine, 23, 591604.
Jernigan, T. L. Zisooks, S. Heaton, R. K. et al (1991) Magnetic resonance imaging abnormalities in lenticular nuclei and cerebral cortex in schizophrenia. Archives of General Psychiatry, 48, 881890.
Kawasaki, Y. Maeda, Y. Urata, K. et al (1993) A quantitative magnetic resonance imaging study of patients with schizophrenia. European Archives of Psychiatry and Clinical Neurosciences, 242, 268272.
Kelsoe, J. R. Cadet, J. L. Picard, D. et al (1988) Quantitative neuroanatomy in schizophrenia. Archives of General Psychiatry, 45, 533541.
Kulynych, J. J. Vladar, K. Jones, D. W. et al (1996) Superior temporal gyrus volume in schizophrenia: a study using MRI morphometry assisted by surface rendering. American Journal of Psychiatry, 153, 5056.
Lawrie, S. M. Ingle, G. T. Santosh, C. G. et al (1995) Magnetic resonance imaging and single photon emission tomography in treatment responsive and treatment resistant schizophrenia. British Journal of Psychiatry, 167, 202210.
Lawrie, S. M. Abukmeil, S. Santosh, C. et al (1997) Qualitative morphological abnormalities in schizophrenia: an MRI study and systematic literature review. Schizophrenia Research, 25, 155166.
Lewis, S. W. (1990) Computerised tomography in schizophrenia: 15 years on. British Journal of Psychiatry, 157 (suppl. 9), 1624.
Lim, K. O. Sullivan, E. V. Zipursky, R. B. et al (1996) Cortical gray matter volume deficits in schizophrenia: a replication. Schizophrenia Research, 20, 157164.
Marsh, L. Suddath, R. L. Higgins, N. et al (1994) Medial temporal lobe structures in schizophrenia: relationship of size to duration of illness. Schizophrenia Research, II, 225238.
Menon, R. R. Barta, P. E. Aylward, E. H. et al (1995) Posterior superior temporal gyrus in schizophrenia: grey matter changes and clinical correlates. Schizophrenia Research, 16, 127135.
Noga, J. T. Aylward, E. Barta, P. E. et al (1995) Cingulate gyrus in schizophrenic patients and normal volunteers. Psychiatry Research: Neuroimaging, 61, 201208.
Nopoulos, P. Torres, I. Flaum, M. et al (1995) Brain morphology in first-episode schizophrenia. American Journal of Psychiatry, 152, 17211723.
O'Callaghan, E. Buckley, P. Redmond, O. et al (1992) Abnormalities of cerebral structure in schizophrenia on magnetic resonance imaging: interpretation in relation to the neurodevelopmental hypothesis. Journal of the Royal Society of Medicine, 85, 227231.
Raz, S. & Raz, N. (1990) Structural brain abnormalities in the major psychoses: a quantitative review of the evidence from computerised imaging. Psychological Bulletin, 108, 93108.
Rossi, A. Stratta, P. Mancini, F. et al (1994) Magnetic resonance imaging findings of amygdala-anterior hippocampus shrinkage in male patients with schizophrenia. Psychiatry Research, 52, 4353.
Schlaepfer, T. E. Harris, G. J. Tien, A. Y. et al (1994) Decreased regional gray matter volume in schizophrenia. American Journal of Psychiatry, 151, 842848.
Shenton, M. E. Kikinis, R. McCarley, R. W. et al (1991) Application of automated MRI volumetric measurement techniques to the ventricular system in schizophrenics and normal controls. Schizophrenia Research, 5, 103113.
Shenton, M. E. Kikinis, R. Jolesz, F. A. et al (1992) Abnormalities of the left temporal lobe and thought disorder in schizophrenia: a quantitative magnetic resonance imaging study New England Journal of Medicine, 327, 604612.
Suddath, R. L. Casanova, M. F. Goldberg, T. E. et al (1989) Temporal lobe pathology in schizophrenia: a quantitative MRI study. American Journal of Psychiatry, 146, 464472.
Suddath, R. L. Christison, G. W. Torrey, E. G. et al (1990) Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia. New England Journal of Medicine, 322, 789794.
Swayze, V. W. Andreason, N. C. Alliger, R. J. et al (1992) Subcortical and temporal structures in affective disorder and schizophrenia: a magnetic resonance imaging study Biological Psychiatry, 32, 221240.
Turetsky, B. Cowell, P. E. Gur, R. C. et al (1995) Frontal and temporal lobe brain volumes in schizophrenia. Archives of General Psychiatry, 52, 10611070.
Van Horn, J. D. & McManus, I. C. (1992) Ventricular enlargement in schizophrenia: a meta-analysis of studies of the ventricle: brain ratio (VBR). British Journal of Psychiatry, 160, 687697.
Vita, A. Dieci, M. Giobbio, G. M. et al (1995) Language and thought disorder in schizophrenia: brain morphological correlates. Schizophrenia Research, 15, 243251.
Ward, K. E. Friedman, L. Wise, A. et al (1996) Meta analysis of brain and cranial size in schizophrenia. Schizophrenia Research, 22, 197213.
Wible, C. G. Shenton, M. E. Hokama, H. et al (1995) Prefrontal cortex and schizophrenia. Archives of General Psychiatry, 52, 279288.
Woodruff, P. W. R. McManus, I. C. & David, A. S. (1995) Meta-analysis of corpus callosum size in schizophrenia. Journal of Neurology. Neurosurgery and Psychiatry, 58, 457461.
Zipursky, R. B. Lim, K. O. Sullivan, E. V. et al (1992) Widespread cerebral grey matter volume deficits in schizophrenia. Archives of General Psychiatry, 49, 195205.
Zipursky, R. B. Marsh, L. Lim, K. O. et al (1994) Volumetric MRI assessment of temporal lobe structures in schizophrenia. Biological Psychiatry, 35, 501506.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Brain abnormality in schizophrenia: A systematic and quantitative review of volumetric magnetic resonance imaging studies

  • Stephen M. Lawrie (a1) and Suheib S. Abukmeil (a1)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *