Volume of the cingulate and outcome in schizophrenia.
BACKGROUND
Previous studies indicated that schizophrenia patients have reduced frontal volumes in comparison with normal, but among schizophrenics, reduced volumes of the posterior (temporal, parietal and occipital) cortex were associated with poor outcome. We examined whether this pattern is seen within the anteroposterior arch of the cingulate gyrus.


METHODS
MR images were acquired in 37 schizophrenia patients (Kraepelinian, n = 13; non-Kraepelinian, n = 24) and 37 controls, and CSF, gray and white matter volumes in individual Brodmann's areas (BA) of the cingulate arch (areas 25, 24, 23, 31, 30, 29) were assessed and examined in relation to outcome.


RESULTS
Schizophrenia patients had significant gray matter reductions in the absolute (mm(3)) volume of Brodmann's area 24 in anterior cingulate and, when corrected for brain size, in the whole cingulate and retrosplenial (areas 29-30) cortex. White matter volumes were increased in right posterior cingulate (area 31). Schizophrenia patients also showed abnormal lateralization of white matter volumes in retrosplenial cortex (area 30) and had lower correlations between frontal and anterior cingulate regions than controls. Poor-outcome subgroup exhibited significant bilateral gray matter deficits in posterior cingulate and retrosplenial cortices compared to good-outcome patients, while no white matter increases in these areas were seen.


CONCLUSIONS
Poor outcome was associated with gray matter deficits in posterior cingulate while compensatory white matter increases in dorsal posterior regions may be related to better outcome. Possible consequences of this may include thought disorder, disturbance of consciousness, treatment resistance, and cognitive decline indicative of a dementing process as a superimposed or inherent part of this schizophrenia subtype.
Mitelman
Serge A
SA
Department of Psychiatry, Neuroscience-PET Laboratory, Box 1505, Mount Sinai School of Medicine, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA. serge.mitelman@mssm.edu
Shihabuddin
Lina
L
Brickman
Adam M
AM
Hazlett
Erin A
EA
Buchsbaum
Monte S
MS
D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D007839:Functional Laterality; D006179:Gyrus Cinguli / Q000002:abnormalities* / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D011795:Surveys and Questionnaires; D013850:Thinking; D016896:Treatment Outcome