B. Bogerts

Limbic pathology in schizophrenia: The entorhinal region—a morphometric study

The volume of the entorhinal region is significantly reduced in postmortem brains of schizophrenics compared with controls (p less than 0.017). In addition, a significant reduction of neurons (p less than 0.017), but no significant increase in absolute glial cell numbers, is found. These results are consistent with the hypothesis that structural changes in the medial temporal lobe of schizophrenics may be developmental in origin.

Hippocampus-Amygdala Volumes and Psychopathology in Chronic Schizophrenia

Volumes of the mesiotemporal structures (hippocampus-amygdala complex) were measured in 19 men who were chronic multiepisode schizophrenics and 18 age-matched healthy controls using T1-weighted contiguous coronal magnetic resonance images of 3.1-mm width. Using the level of the mammillary bodies as an anatomical landmark, the whole hippocampus-amygdala complex was divided into an anterior section (mainly containing amygdaloid tissue) and a posterior section (mainly containing the hippocampal formation). Total mesiotemporal tissue volume was reduced significantly in the patient group compared to controls (-11%), with significant reductions in both left (-20%) and right (-15%) hippocampal sections. Reduced limbic tissue volume was associated with increased severity of psychopathology. Severity of positive psychotic symptoms (Brief Psychiatric Rating Scale [BPRS] psychosis factor) was correlated significantly with right and left total mesiotemporal volumes (Spearman rhos = -0.61 p < 0.01). Negative symptom scores (BPRS anergia factor, Scale for Assessment of Negative Symptoms [SANS] global items) were not significantly correlated with any mesiotemporal tissue volumes. The data corroborate and extend previous findings of temporolimbic structure volume reduction in schizophrenia, and suggest that the positive psychotic symptoms of schizophrenia are associated with anatomic anomalies in mesiotemporal structure.

Gliosis in schizophrenia: A survey

Increased gliosis has been previously described in schizophrenic brain. In this study, the degree of gliosis in schizophrenic and control brains was assessed quantitatively using an antibody to glial fibrillary acidic protein, immunocytochemical techniques, and a computed image analysis system. Twenty separate brain areas were assessed, and no significant differences were found between the schizophrenic and control groups. It seems unlikely that a specific pattern of pathologically significant gliosis is present in schizophrenic brains. These negative findings are of note because of previously reported structural differences in the temporal lobe in the schizophrenic group in this series.

Qualitative magnetic resonance imaging findings in geriatric depression. Possible link between later-onset depression and Alzheimer's disease?

BACKGROUND Several clinical and neuroimaging investigations support the notion that underlying brain changes may relate to depression in older patients, especially those with a later-age initial episode. However uncertainty still exists about diagnostic and pathogenic significance of structural brain abnormalities in aged depressives, in part because many studies lack all-elderly and age-similar normal comparison populations. METHODS Brain morphology of elderly depressives (N = 30) and normal controls (N = 36) was compared by assessing magnetic resonance imaging (MRI) brain scans with qualitative criteria-based scales. Ratings included lateral and third ventricle enlargement, and cortical, medial temporal, and caudate atrophy. RESULTS Significant differences between depressed and control groups were not demonstrated. Later-onset depressives had significantly more left medial temporal and left caudate atrophy than early-onset counterparts of similar age. Medial temporal atrophy significantly correlated with cognitive impairment and was not related to physical illness. Depressives with medial temporal atrophy (N = 7) were older and had later age at onset of depression than those without such changes. Cerebrovascular disease risk factors did not predict MRI abnormalities. CONCLUSIONS Results indicate non-specificity and lack of homogeneity of qualitatively measured structural brain changes in geriatric depression, but suggest that pathology of specific, lateralized brain regions may be implicated in some later-onset patients. The relationship between medial temporal atrophy and late-onset depression raises the possibility that such patients may suffer from as-yet undeclared Alzheimers disease. Lack of association between cerebrovascular disease risk factors and brain changes suggests other pathophysiological contributions.

Quantitative study of gliosis in schizophrenia and huntington's chorea

Etude comparative de la proliferation gliale au niveau du noyau caude dans les encephales de patients choreiques et de patients schizophrenes

Family history and brain morphology in schizophrenia: An MRI study

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.

Negative Symptoms in Schizophrenia: Relationship to Positive Symptoms and Outcome

The diagnostic criteria for schizophrenia have historically been based predominantly on the so-called positive symptoms, i.e., delusions, hallucinations, thought disorganization. This is not to say that the significance of negative symptom psychopathology, i.e., deficits of affect, drive, interest, speech, and thought, has been minimized, but rather less well characterized and understood. Reported differences between positive and negative symptoms in their pharmacologic response (Csernansky et al. 1986; Huber et al. 1980; Johnstone et al. 1983; Kay and Opler 1987) and pathobiologic correlates have been interpreted as evidence that these symptom clusters reflect different pathophysiologic processes or substrates (Andreasen 1982; Andreasen and Olsen 1982; Andreasen et al. 1982; Crow 1980a, b). In addition, follow-up studies indicating that negative symptoms are associated with a more chronic course of illness and poorer outcomes have been taken as evidence that negative symptom psychopathology may reflect a specific subtype of schizophrenia (Carpenter et al. 1988; Crow 1985; Kay et al. 1986; Pogue-Geile and Harrow 1984).

Gadolinium-DTPA enhanced gradient echo magnetic resonance scans in first episode of psychosis and chronic schizophrenic patients

Ten male schizophrenic patients underwent Gadolinium-DTPA (Gd-DTPA) enhanced magnetic resonance (MR) imaging to determine the utility of paramagnetic contrast agents in evaluating neuropathology. MR images enhanced by Gd-DTPA demonstrated no defect in the integrity of the blood-brain barrier.

Brain morphometric comparison of first episode schizophrenia and temporal lobe epilepsy

BACKGROUND Converging evidence has suggested that the abnormalities in brain morphology observed in schizophrenia are similar to those seen in temporal lobe epilepsy (TLE). The purpose of this study was to compare the features of these groups directly with measures of the brain using magnetic resonance (MR) morphometry. METHOD Morphometric measures of ventricular and hippocampal volumes obtained from FLASH MR images were studied in 32 patients with first-episode schizophrenia (FES), 39 patients with TLE (21 left, 18 right), and 42 healthy controls. RESULTS Ventricular volumes in the FES and TLE groups were both significantly larger that those seen in controls and did not differ from each other. The FES group showed significantly larger temporal horns, while the TLE group had relatively larger frontal horns. Analyses of hippocampal volumes revealed a significant group by hemisphere effect. The FES group showed relative reductions in left hippocampal volume that were comparable only to TLE patients with seizures originating from the left hemisphere. CONCLUSION The results indicate that FES and TLE groups both show evidence of ventricular enlargement. Lateralised morphological abnormalities of the hippocampal formation in FES and left TLE are comparable, and may be specific to temporolimbic regions.

Hippocampus and Basal Ganglia Pathology in Chronic Schizophrenics. A Replication Study from a New Brain Collection

In two previous papers (Bogerts 1984; Bogerts et al. 1985) we reported reduced volumes of limbic medial temporal lobe and basal ganglia structures in postmortem brains of schizophrenics belonging to the Vogt collection in Dusseldorf. A number of subsequent planimetric postmortem and MRI studies (Table 1) also reported anatomical anomalies in limbic structures of schizophrenics, whereas in two recent studies, which were based in part on very old cases (Heckers et al. 1989, 1990), no significant volume reductions of hippocampus, parahippocampal gyrus, and amygdala could be found.