MRI study of caudate nucleus volume and its cognitive correlates in neuroleptic-naive patients with schizotypal personality disorder.
OBJECTIVE
"Cognitive" circuits anatomically link the frontal lobe to subcortical structures; therefore, pathology in any of the core components of these circuits, such as in the caudate nucleus, may result in neurobehavioral syndromes similar to those of the frontal lobe. Neuroleptic medication, however, affects the size of the caudate nucleus. For this reason, individuals diagnosed with schizotypal personality disorder offer an ideal group for the measurement of the caudate nucleus because they may be genetically related to individuals with schizophrenia but do not require neuroleptic treatment because of their less severe symptoms.


METHODS
Magnetic resonance imagining (MRI) scans obtained on a 1.5-T magnet with 1.5-mm contiguous slices were used to measure the caudate nucleus and lateral ventricles in 15 right-handed male subjects with schizotypal personality disorder who had no previous neuroleptic exposure and in 14 normal comparison subjects. Subjects were group matched for parental socioeconomic status, handedness, and gender.


RESULTS
First, the authors found significantly lower left and right absolute (13.1%, 13.2%) and relative (9.1%, 9.2%) caudate nucleus volumes in never-medicated subjects with schizotypal personality disorder than in normal subjects. Second, they found significant, inverse correlations between caudate nucleus volume and the severity of perseveration in two distinct working memory tasks in these neuroleptic-naive subjects with schizotypal personality disorder.


CONCLUSIONS
These data are consistent with the findings of reduced caudate nucleus volume reported in studies of neuroleptic-naive patients experiencing their first episode of schizophrenia and support the association of intrinsic pathology in the caudate nucleus with abnormalities in working memory in the schizophrenia spectrum.
Levitt
James J
JJ
Clinical Neuroscience Division, Laboratory of Neuroscience, Dept. of Psychiatry, VA Boston Healthcare System-Brockton Division, Harvard Medical School, 940 Belmont Street, Brockton, MA 02301, USA.
McCarley
Robert W
RW
Dickey
Chandlee C
CC
Voglmaier
Martina M
MM
Niznikiewicz
Margaret A
MA
Seidman
Larry J
LJ
Hirayasu
Yoshio
Y
Ciszewski
Aleksandra A
AA
Kikinis
Ron
R
Jolesz
Ferenc A
FA
Shenton
Martha E
ME
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage; D002421:Caudate Nucleus / Q000033:anatomy & histology*; D002552:Cerebral Ventricles / Q000033:anatomy & histology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000453:epidemiology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D012565:Schizophrenic Psychology; D012569:Schizotypal Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012737:Sex Factors
D014150:Antipsychotic Agents