Prefrontal abnormalities in patients with simple schizophrenia: structural and functional brain-imaging studies in five cases.
Simple schizophrenia is an uncommon disorder with unknown pathophysiology, and its position in the current diagnostic system is ambiguous. Brain-imaging studies may help to elucidate its pathophysiology. Five patients fulfilling both ICD-10 criteria for simple schizophrenia and DSM-IV criteria for simple deteriorative disorder underwent computed tomography, magnetic resonance imaging, and single photon emission computed tomography. These scans were assessed individually by visual inspection as well as automatically by comparison with scans in normal controls or other schizophrenia subtype patients using voxel-based image analyses. Three of the five simple schizophrenia patients had findings of atrophy and reduced cerebral perfusion in the frontal areas. Voxel-based analyses also showed prefrontal grey matter deficits and hypoperfusion in simple schizophrenia patients compared with the controls. Although this study is limited by the small number of patients with simple schizophrenia, the results suggest that simple schizophrenia, or at least this subpopulation, may have rather homogeneous morphological and functional deficits in the prefrontal cortex. It is also suggested that simple schizophrenia may occupy an extreme position of the schizophrenic continuum where the prefrontal deficits and negative symptoms are most purely manifested.
Suzuki
Michio
M
Department of Neuropsychiatry, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan. suzukim@ms.toyama-mpu.ac.jp
Nohara
Shigeru
S
Hagino
Hirofumi
H
Takahashi
Tsutomu
T
Kawasaki
Yasuhiro
Y
Yamashita
Ikiko
I
Watanabe
Naoto
N
Seto
Hikaru
H
Kurachi
Masayoshi
M
D000328:Adult; D002560:Cerebrovascular Circulation / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000002:abnormalities / Q000098:blood supply / Q000000981:diagnostic imaging; D012559:Schizophrenia / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed