P. Falkai

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.

Post-mortem volume measurements of limbic system and basal ganglia structures in chronic schizophrenics: Initial results from a new brain collection

Volumes of the hippocampal formation, external and internal pallidum, caudate, putamen, and nucleus accumbens were measured in both hemispheres of recently collected post-mortem brains of 18 chronically ill schizophrenics and 21 control subjects. In the schizophrenic group, the hippocampal formation and the internal pallidum were significantly smaller in the right and left hemisphere, whereas external pallidum, putamen, caudate and accumbens were not significantly changed. Volumes of the hippocampus and of all evaluated parts of the basal ganglia were in the male schizophrenics more reduced than in the female patients. The right and left hemispheres were equally affected in both sexes. Since the mean brain weight was in patients and controls nearly identical, the volume differences can not be explained by a general brain atrophy or hypoplasia but rather indicate a more focal lack of brain tissue, by which some clinical features of the disease might be explained.

Disturbed planum temporale asymmetry in schizophrenia. A quantitative post-mortem study.

The planum temporale of the temporal cortex was investigated post-mortem in 24 schizophrenic patients and 24 age- and sex-matched control subjects. Schizophrenic patients demonstrated a 20% volume reduction of the left planum temporale (p = 0.032), whereas on the right side, there was a trend for increase in male schizophrenics (+22%, p = 0.17), while in female patients the volume was moderately decreased (-6%, p = 0.74). The mean anterior-posterior diameter of the planum temporale was significantly reduced in the left hemisphere (-20%, p = 0.008), but unchanged on the right side. The asymmetry coefficients (Galaburda et al. (1987) Neuropsychologia 25, 853-868) for the planum temporale cortex volume (p = 0.02) and anterior-posterior diameter (p = 0.002) but not for mean area (p = 0.61) were significantly different between schizophrenics and control subjects. These data support the idea of disturbed cerebral laterality in schizophrenia. The implications of methodology and patient samples are discussed.

Loss of sylvian fissure asymmetry in schizophrenia. A quantitative post mortem study.

The sylvian fissure is known to be one of the most asymmetric structures of the human brain. Sylvian fissure length was measured in post-mortem brains of 35 schizophrenic patients and 33 matched non psychiatric control subjects. The schizophrenics showed a significantly reduced length of the left sylvian fissure (-16%, p less than 0.0001) compared to the control subjects, while the right sylvian fissure length was unchanged. Sylvian fissure asymmetry (left/right ratio) was more reduced in male schizophrenics (-24%, p less than 0.001) than in female patients (-16%, p less than 0.03). This finding is consistent with several post-mortem and MRI studies showing left temporal lobe pathology in a significant proportion of patients and may indicate that schizophrenia is a disorder of early neurodevelopment causing impaired cerebral lateralization.

In vivo morphometry of planum temporale asymmetry in first-episode schizophrenia

Magnetic resonance imaging is a promising tool for in vivo analysis of the neuropathology underlying schizophrenia. One of the most consistent features emerging from the majority of published studies is the lateralization of pathological findings, and this has led to hypotheses of impaired hemispheric specialization in schizophrenia. In previous work, we have validated morphometry of supratemporal language-related cortex using high-resolution magnetic resonance imaging and analyzed the relation of the so defined planum temporale to functional parameters of hemispheric specialization. In the present study, we examined planum temporale structural asymmetry in first-episode schizophrenics. Asymmetry coefficients obtained in these patients did not differ significantly from those in equally right-handed controls and were not correlated to standard psychopathological measures. These data are contrasted with other studies reporting lateralized brain pathology in schizophrenia with special emphasis on methodological considerations in neuroimaging procedures.

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

Brain morphology assessed by computed tomography in patients with geriatric depression, patients with degenerative dementia, and normal control subjects

To determine whether patients with geriatric depression have specific alterations in brain morphology, internal (ventricles) and external (frontal, temporal, and parieto-occipital) components of the cerebrospinal fluid (CSF) spaces were examined. Planimetric measurements of computed tomographic (CT) scans from patients with geriatric depression were compared with measurements from two age- and sex-matched control groups: normal control subjects and patients with primary degenerative dementia. Scans of 34 patients (6 men, 28 women; mean age = 70.7 years) who met DSM-III-R diagnostic criteria for major depression, 29 patients with DSM-III-R primary degenerative dementia (8 men, 21 women; mean age = 71.2 years), and 43 nonpsychiatric control subjects (10 men, 33 women; mean age = 70.8 years) were evaluated. The areas of the frontal and parieto-occipital sulci, the Sylvian fissures, and the lateral and third ventricles were measured separately for the right and left hemispheres. Compared with the control subjects, patients with geriatric depression revealed a remarkable enlargement (up to 125%) of the left Sylvian fissure on several levels and a more subtle enlargement of the ventricles, cortical sulci, and right Sylvian fissure (20-50%). The laterality index differed significantly between depressed patients and normal control subjects (but not between the demented patients and the normal control group) only for the Sylvian fissure. Demented patients showed a considerable brain atrophy that affected all CSF components (enlargement of 30-160%) but the left temporal region was less affected than in the depressed patients. Compared with the findings in geriatric depression, ventricular enlargement was significant in dementia.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical and Neurodevelopmental Aspects of Brain Pathology in Schizophrenia

After the failure of classical neuropathological schizophrenia research to convincingly demonstrate anatomical anomalies in the brains of schizophrenics, a new era of pathomorphological interest in schizophrenia started some 10 years ago. It received strong impetus from modern neuroimaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), and regional cerebral blood flow (rCBF) studies as well as from new morphometric post mortem methods.

Reduced frontal and occipital lobe asymmetry on the CT-scans of schizophrenic patients. Its specificity and clinical significance

Frontal and occipital lobe width were determined in the computed tomographic (= CT) scans of 135 schizophrenic patients, 158 neuropsychiatrically healthy and 102 psychiatric control subjects, including patients with affective psychosis, neurosis and schizoaffective psychosis. Most healthy right handed subjects demonstrate a relative enlargement of the right frontal as well as left occipital lobe compared to the oposite hemisphere. These normal frontal and occipital lobe asymmetries were selectively reduced in schizophrenics (f.: 5%, p <.0005; o.: 3%, p <.05), irrespective of the psychopathological subgroup. Schizophrenic neuroleptic non-responders revealed a significant reduction of frontal lobe asymmetry (3%, p <.05), while no correlation between BPRS-subscores and disturbed cerebral laterality could be detected. In sum the present study demonstrates disturbed cerebral lateralisation in schizophrenic patients supporting the hypothesis of interrupted early brain development in schizophrenia.

Gestörte zerebrale Lateralität im CT Schizophrener Eine morphometrische Studie

Im Computertomogramm zeigt sich bei gesunden rechtshandigen Mannern und Frauen eine relative Erweiterung des rechten Frontal- bzw. linken Okzipitallappens gegenuber der kontralateralen Seite [1]. Diese Asymmetrie scheint bei einigen Erkrankungen des Zentralnervensystems wie der Dyslexie und dem Autismus gestort zu sein. Zwei von 14 computertomographischen Studien fanden auch bei Schizophrenen eine gestorte frontale und okzipitale Asymmetrie, 9 konnten eine gestorte zerebrale Lateralisierung zumindest fur Untergruppen schizophrener Patienten nachweisen. Die vorliegende Studie wurde an einer relativ grosen Gruppe von ersterkrankten schizophrenen Patienten und neuropsychiatrisch unauffalligen Kontrollen durchgefuhrt, um zu prufen, ob eine Storung der Lateralisierung das gesamte Gehirn Schizophrener betrifft oder ob es sich hier um ein fokales temporo-parietales Geschehen handelt, wie neuere post-mortem Studien vermuten lassen [2, 3].