Altered white matter/gray matter proportions in the striatum of patients with schizophrenia: a volumetric MRI study.

OBJECTIVE: Anatomical structures of the striatum were studied in 58 patients with schizophrenia and 56 healthy comparison subjects of both genders matched for age and handedness. METHOD: Magnetic resonance imaging scans were used to measure gray matter, white matter, and CSF volumes of the caudate, putamen, and nucleus accumbens in the left and the right hemispheres. RESULTS: White matter/gray matter ratios of the striatal structures were significantly lower in patients than in healthy subjects. In patients, relative white matter volumes in the caudate and nucleus accumbens were reduced, whereas gray matter in the putamen was increased. The total accumbens volume did not differ by diagnosis, but left side accumbens was larger than right in the healthy subjects. The proportion of white matter was greater in women in both the patient and healthy comparison groups. Total caudate and putamen volumes demonstrated no differences due to diagnosis or laterality, but a negative correlation was found in patients between white matter volumes and increasing age. There were no significant correlations among total striatal volumes, white matter/gray matter ratios, age at onset of illness, or illness duration. An estimate of lifetime neuroleptic consumption was positively correlated with right gray matter volume of the putamen in male schizophrenia patients who received typical neuroleptics. CONCLUSIONS: The proportion of white matter to gray matter tissue volumes of the caudate, putamen, and nucleus accumbens is altered in medicated chronic schizophrenia patients, but the total volumes are unchanged.

Frontal and temporal volume size of grey and white matter in patients with schizophrenia: an MRI parcellation study.

We previously performed a magnetic resonance imaging (MRI) parcellation study that showed smaller grey and white matter volumes of the temporal lobes and increased CSF volumes in the frontal and temporal lobe in men with schizophrenia. One question that arose from this earlier study was whether similar structural changes in the brain are found in a large group of schizophrenic patients consisting of both men and women. In the present study, MRI scans were acquired from 94 patients of both genders with schizophrenia and 101 healthy subjects. After the automatic segmentation of grey matter, white matter, and cerebrospinal fluid, the frontal, temporal, parietal, and occipital lobes were automatically parcellated according to the Talairach atlas. Compared with healthy subjects, schizophrenic patients showed significantly smaller volumes of grey matter in the temporal lobe and white matter in the frontal lobe. Schizophrenic patients had a greater CSF volume in the frontal and temporal lobes. These results suggest that volume reduction in the cerebrum is prominent in the frontal and temporal lobes in both men and women with schizophrenia.

Successful electroconvulsive treatment of depression associated with a marked reduction in the symptoms of tardive dyskinesia.

This report describes improvement of tardive dyskinesia (TD) in a patient who received electroconvulsive therapy (ECT) for depression. The patient, an elderly Asian male, was treated for major depression with ECT and showed a rapid improvement of TD that may have been caused by any number of drugs or combination of drugs. We discuss the possibility of improving TD by treating the depression with ECT.

Reduced white matter volume of the caudate nucleus in patients with schizophrenia.

To examine volumetric abnormality, the caudate nucleus was measured in patients with schizophrenia and healthy subjects using magnetic resonance imaging. The absolute and relative volumes of white matter in the caudate nucleus were found to be significantly smaller in patients with schizophrenia compared to those in healthy subjects. There were significant correlations between dosages of neuroleptics during the previous year and absolute gray matter volumes of the caudate nucleus as well as relative white matter volumes in patients with schizophrenia. These findings suggest that reduced white matter volume of the caudate nucleus may be a factor affecting the abnormal connectivity of the corticostriatal loop, and that neuroleptic medication would be related to white matter alteration in patients with schizophrenia. Our result replicates a previous study reporting that there is a lack of negative correlation between age and caudate nucleus volume. We also suggest that the disease process of schizophrenia might interfere with normal aging.

Subtle disruption of the middle cerebellar peduncles in patients with schizophrenia.

Diffusion tensor imaging (DTI) was used to investigate subtle disruption in the middle cerebellar peduncles in patients with schizophrenia. Fractional anisotropy (FA) was measured in 25 patients with schizophrenia and 21 healthy subjects using DTI. The FA of the right and left middle cerebellar peduncles was significantly lower in the schizophrenic patients compared to healthy subjects. FA in the left middle cerebellar peduncles was significantly correlated with the dosage of neuroleptics in patients with schizophrenia. There were no significant differences of mean diffusivity in the right and left middle cerebellar peduncles between patients with schizophrenia and healthy subjects. The findings of the study suggest that antipsychotics may improve the subtle disruption in the middle cerebellar peduncles in patients with schizophrenia.

Inter- and intraoperator reliability of brain tissue measures using magnetic resonance imaging.

Grey matter, white matter and cerebrospinal volume in the human brain were measured using magnetic resonance image analysis software BRAINS. Ten volunteers were scanned in the MR sequence (3D-SPGR; 1.5-mm slice thickness and T2 images; 3mm slice thickness). Two operators obtained ten volume measures of grey matter,white matter and cerebrospinal fluid (CSF) in the intracranial box, frontal box, temporal box, parietal box and occipital box. The same data set of ten scans was segmented and the volumes measured on a second occasion by one operator using the same procedure. The interoperator and intraoperator reliabilities for measures of the three brain tissues were very good, with reliability coefficients (intraclass correlation coefficients) ranging between 0.971 and 0.999. The segmentation and measurement are useful for volumetric studies in the human brain using BRAINS.