RESUMO
Patients with schizophrenia exhibit abnormalities in midsagittal corpus callosum area, shape, and/or displacement. Our goal was to confirm these findings and to establish the genetic and nongenetic contributions to altered callosal morphology in schizophrenia. Relationships between ventricular enlargements potentially contributing to callosal displacements were assessed as a secondary goal. High-resolution magnetic resonance images were obtained from co-twins of monozygotic and dizygotic pairs discordant for schizophrenia and healthy control twins (N = 40 pairs). Investigators blind to group status segmented the corpus callosum and ventricles in native brain volumes aligned using a rigid-body transformation with no scaling. Total and parcellated midsagittal callosal areas and measures indexing vertical displacements of the corpus callosum were used in statistical tests to identify schizophrenia and sex effects and to dissociate genetic and nongenetic influences on morphology. Anatomical mesh modeling methods provided group average and surface variability maps of the callosum. Callosal areas did not differ between groups defined by sex or biological risk. Vertical displacements of the callosum, pronounced in male patients, were confirmed in schizophrenia and observed between dizygotic, but not monozygotic co-twins discordant for schizophrenia. Like their affected twins, however, unaffected monozygotic co-twins of the schizophrenia probands exhibited significant callosal displacements. Lateral and third ventricle enlargements were related to callosal displacements. Results clearly support that genetic rather than disease-specific or shared environmental influences contribute to altered callosal morphology in schizophrenia. An upward bowing of the callosum may thus provide an easily identifiable neuroanatomic marker to screen individuals possessing a biological vulnerability for schizophrenia.
Assuntos
Corpo Caloso/anatomia & histologia , Corpo Caloso/patologia , Imageamento por Ressonância Magnética , Esquizofrenia/diagnóstico , Esquizofrenia/genética , Mapeamento Encefálico/métodos , Ventrículos Cerebrais/anatomia & histologia , Ventrículos Cerebrais/patologia , Estudos de Coortes , Doenças em Gêmeos/diagnóstico , Doenças em Gêmeos/epidemiologia , Doenças em Gêmeos/genética , Feminino , Finlândia/epidemiologia , Humanos , Processamento de Imagem Assistida por Computador/estatística & dados numéricos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Fenótipo , Valor Preditivo dos Testes , Valores de Referência , Reprodutibilidade dos Testes , Esquizofrenia/epidemiologia , Gêmeos Dizigóticos , Gêmeos MonozigóticosRESUMO
Hippocampal volume reductions are widely observed in schizophrenia. Some studies suggest anterior hippocampal regions are more susceptible and associated with frontal lobe dysfunctions, while others implicate posterior regions. Using high-resolution MR images and novel computational image analysis methods, we identified the hippocampal subregions most vulnerable to disease processes in 62 (45 m/17 f) first-episode schizophrenia patients compared to 60 (30 m/30 f) healthy controls, similar in age. The hippocampi were traced on coronal brain slices and hemispheric volumes were compared between diagnostic groups. Regional structural abnormalities were identified by comparing distances, measured from homologous hippocampal surface points to the central core of each individual's hippocampal surface model, between groups in 3D. CSF concentrations were also compared statistically at homologous hippocampal surface points to localize corresponding gray matter reductions. Significant bilateral hippocampal volume reductions were observed in schizophrenia irrespective of brain size corrections. Statistical mapping results, confirmed by permutation testing, showed pronounced left hemisphere shape differences in anterior and midbody CA1 and CA2 regions in patients. Significant CSF increases surrounding the hippocampus were observed in a similar spatial pattern in schizophrenia. Results confirm that hippocampal volume reductions are a robust neuroanatomical correlate of schizophrenia and are present by first episode. Mid- to antero-lateral hippocampal regions show pronounced volume changes and complementary increases in peri-hippocampal CSF, suggesting that these hippocampal regions are more susceptible to disease processes in schizophrenia. Targeting regional hippocampal abnormalities may help dissociate schizophrenia patients from other groups exhibiting global hippocampal volume changes, and better focus systems-level pathophysiological hypotheses.