Rightward cerebral asymmetry in subtypes of schizophrenia according to Leonhard's classification and to DSM-IV: a structural MRI study.
Although well documented, brain structural abnormalities in schizophrenia are non-specific, and morphometric parameters show significant overlap between patients and healthy controls. Such inconsistencies in neuroimaging findings could represent different levels of severity along a single pathogenic process or distinct clinical and etiopathological psychoses within a schizophrenic spectrum. The aim of the present study was the investigation of distinct brain abnormalities in different subtypes of schizophrenia. Forty patients were classified according to DSM-IV and Leonhard's classifications. Psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS) and the Negative Symptom Rating Scale (NSRS). Patients were compared to 20 healthy volunteers on volumetric measures of cerebral structures (hemisphere, hippocampus and planum temporale) and ventricular-brain ratio (VBR) obtained by magnetic resonance imaging. Patients showed rightward asymmetry of cerebral hemispheres and increased VBR. Rightward asymmetry correlated with severity of negative symptoms and prevailed in the systematic forms of Leonhard, suggesting a distinct pattern of left hemisphere abnormality in this subgroup of psychoses. Increased VBR values showed a single normal distribution in the subgroups, indicating that ventricular enlargement is not restricted to a subgroup but is present to a certain degree in all cases.
Department of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Ovidio Pires de Campos s/n, São Paulo CEP 05403-010, Brazil.
Paulo C
PC
Sallet
Helio
H
Elkis
Tânia M
TM
Alves
José R
JR
Oliveira
Erlei
E
Sassi
Claudio Campi
CC
de Castro
Geraldo F
GF
Busatto
Wagner F
WF
Gattaz
D000328:Adult; D001921:Brain / Q000002:abnormalities*; D002552:Cerebral Ventricles / Q000002:abnormalities; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis*