Qualitative assessment of brain morphology in acute and chronic schizophrenia.
OBJECTIVE
Neuroimaging studies of brain morphology in schizophrenia have used predominantly morphometric techniques to assess brain scans. However, as currently implemented, such methods are not particularly helpful in the routine assessment of individual patients. The purpose of this study was to evaluate brain morphology seen with magnetic resonance imaging (MRI) by qualitative assessment, the most frequently used method in clinical practice for evaluating brain scans.


METHODS
First-episode (N = 62) and chronic, multi-episode (N = 24) schizophrenic patients and healthy comparison subjects (N = 42) underwent MRI of the whole head in a sequence that provided 63 contiguous brain slice images. Each subject received a rating of normal, questionably abnormal, or definitely abnormal for four brain regions (lateral ventricles, third ventricle, medial temporal lobe structures, and frontal/parietal cortex) and a global rating.


RESULTS
The schizophrenic patients had significantly higher global rates of abnormal morphology (first-episode group, 31%; chronic group, 42%) than the normal subjects (5%). The highest regional rates of abnormalities were seen in the lateral ventricles and the lowest in the frontal/parietal cortex. Although the chronic patients had generally higher abnormal rates than the first-episode patients, these differences were not statistically significant. The qualitative ratings of brain morphology were significantly correlated with quantitative assessments performed in separate studies.


CONCLUSIONS
Despite its limits in sensitivity (and until quantitative morphometric techniques are made practical and more widely available), qualitative evaluation of MRI scans can be a useful technique in research and clinical evaluation of patients with schizophrenia.
Lieberman
J
J
Department of Psychiatry, Long Island Jewish Medical Center, Albert Einstein College of Medicine, Glen Oaks, NY 11004.
Bogerts
B
B
Degreef
G
G
Ashtari
M
M
Lantos
G
G
Alvir
J
J
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000033:anatomy & histology* / Q000473:pathology; D002540:Cerebral Cortex / Q000033:anatomy & histology / Q000473:pathology; D002552:Cerebral Ventricles / Q000033:anatomy & histology / Q000473:pathology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D012559:Schizophrenia / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity; D012737:Sex Factors