Association between excessive frontal cerebrospinal fluid and illness duration in males but not in females with schizophrenia.
OBJECTIVE
Excessive cortical cerebrospinal fluid (CSF) has been acknowledged as a possible marker of a gray matter loss. This excess in schizophrenia is found predominantly in the prefrontal and temporal regions. We hypothesized that the poorer global outcome and treatment response in males with schizophrenia are related to a greater cortical volume loss as compared to females.


METHODS
In order to test this hypothesis we have used magnetic resonance imaging (MRI) to study the cortical (prefrontal, temporal, and hemispheric) CSF values in a group of 85 patients with schizophrenia, of whom 56 were males and 29, females. We calculated the residual values of CSF in the patients based on the data pertaining to 45 control subjects and linear regression, from which the normal effects of age and intracranial volume were discounted. These residual scores constitute a quantitative measurement of the excess of CSF due to the disease.


RESULTS
Males, but not females, presented a trend-level significant excess of left prefrontal CSF. The prefrontal and temporal residual values were significantly associated with illness duration in males, but not in females.


CONCLUSIONS
These results conform to the worse outcome and the higher severity of structural abnormalities generally found in schizophrenia in male subjects.


CONCLUSIONS
Our data support the hypothesis of accelerated prefrontal cortical loss in males, but not in females with schizophrenia.
Molina
Vicente
V
Department of Psychiatry, Hospital Clínico Universitario, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain. vmolina@usal.es
Sanz
Javier
J
Sarramea
Fernando
F
Misiego
José M
JM
Benito
Carlos
C
Palomo
Tomás
T
D000328:Adult; D001284:Atrophy; D002555:Cerebrospinal Fluid / Q000502:physiology*; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D017397:Prefrontal Cortex / Q000473:pathology*; D011569:Psychiatric Status Rating Scales; D012016:Reference Values; D012559:Schizophrenia / Q000175:diagnosis*; D012737:Sex Factors; D013702:Temporal Lobe / Q000473:pathology*