Volumetric Brain MRI Study in Patients with First Episode Schizophrenia

Shin, Sang Eun; Kang, Min Hee; Lee, Jeong Seop; Kim, Chul Eung; Bae, Jae Nam; Choi, Sung Wook

Abstract

OBJECTIVES
To demonstrate the structural pathogenesis of schizophrenia, this study measures cerebral and cerebellar volumes of antipsychotics-navie and first episode schizophrenic patients. Also this study analyzes morphological character of patients with early schizophrenia.
METHODS
Volume segmentation incorporating MRI scanning was performed on 25 patients with schizophrenia(mean age: 31.2+/-7.85yr, ranging: 14-18yr) and a control group of 29 healthy dindividuals(mean age: 29.03+/-7.02yr, ranging: 18-42yr). To carry out segmentation, the cerebrum and cerebellum were partitioned by gray matter, white matter and cerebrospinal fluid using a probabilistic histologic algorithm. These images of the segments were defined as the frontal, parietal, temporal and occipital lobes and cerebellum by using the semi-automated technique based on the atlas developed by Talairach. The area of dimension for each fraction was measured and its symmetry was compared. A statistical analysis was performed using the analysis of covariance by compensating the total brain volume with the level of covariance.
RESULTS
The total brain volume of the schizophrenic patient group was significantly smaller than that of the control group(t=-1.986, d.f.=38.97, p=0.05). Female patients with schizophrenia showed a smaller right cerebellar volume than the female controls(F=4.20, d.f.=(1,51), p=0.046). Female with schizophrenia showed a larger left frontal white matter volume than their female controls and male with schizophrenia showed a smaller right frontal white matter volume than their male controls(F=6.89, d.f.=(1,51), p=0.012). Male patients with schizophrenia showed a larger right occipital white matter volume than the male controls. Females with schizophrenia showed a larger left occipital white matter volume than their female controls and male with schizophrenia showed a smaller left occipital white matter volume than their male controls(F=3.97, d.f.=(1,51), p=0.050). Female patients with schizophrenia showed a larger parietal white matter volume than the female controls(F=6.14, d.f.=(1,51), p=0.017). Female patients with schizophrenia also showed a smaller right and left cerebellar gray matter volume than the female controls(F=3.90, d.f.=(1,51), p=0.050). Female patients with schizophrenia also showed a smaller temporal gray matter volume than the female controls(F=4.74, d.f.=(1,51), p=0.034).
CONCLUSION
These results demonstrate that the cerebellum and frontal lobe are involved in pathogenesis of schizophrenia, difference of white matter between schizophrenic patient and control is an important finding that suggest the importance of cortical dysconnection syndrome as pathophysiology on schizophrenia, and these findings suggest that pathogenesis of schizophrenia include many areas of brain.