title: White matter fractional anisotropy and outcome in schizophrenia.
abstract: OBJECTIVE
  Disparate white matter fractional anisotropy (FA) findings have been reported in patients with schizophrenia in recent years. This may in part reflect heterogeneity of subjects in the studies, including differences in outcome and severity of the illness. We examined whether there is a relationship between white matter FA and outcome in patients with schizophrenia.
  
  
  METHODS
  Diffusion-tensor images were obtained in 41 normal subjects and 104 patients with schizophrenia, divided into good-outcome (n=51) and poor-outcome (Kraepelinian; n=53) subtypes based on their ability for self-care. White matter FA and its relationship to regional tissue volumes were evaluated across 40 individual Brodmann's areas using a semi-automated parcellation technique.
  
  
  RESULTS
  Overall white matter FA was lower in schizophrenia patients than normal subjects, with regional reductions in widespread temporoparietal and selected prefrontal white matter regions. In schizophrenia patients, lower regional white matter FA was associated with lower regional gray matter volumes. In comparison to normal subjects, overall white matter FA was reduced in patients with poor outcomes in both hemispheres, but to a lesser extent and only in the right hemisphere in good-outcome patients. Lower regional FA was associated with larger regional white matter volumes in good-outcome group.
  
  
  CONCLUSIONS
  Global FA reductions implicate white matter as tissue type in the pathophysiology of schizophrenia. In contrast to poor outcome, good outcome in schizophrenia patients may be associated with less extensive FA reductions, higher FA in regional frontal and cingulate white matter, and correlated increases in regional white matter volumes, particularly in the left hemisphere.
authors.affiliation: Department of Psychiatry, Neuroscience-PET Laboratory, Box 1505, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA. serge.mitelman@mssm.edu
authors.forename: Serge A
authors.initials: SA
authors.lastname: Mitelman
authors.forename: Randall E
authors.initials: RE
authors.lastname: Newmark
authors.forename: Yuliya
authors.initials: Y
authors.lastname: Torosjan
authors.forename: King-Wai
authors.initials: KW
authors.lastname: Chu
authors.forename: Adam M
authors.initials: AM
authors.lastname: Brickman
authors.forename: M Mehmet
authors.initials: MM
authors.lastname: Haznedar
authors.forename: Erin A
authors.initials: EA
authors.lastname: Hazlett
authors.forename: Cheuk Y
authors.initials: CY
authors.lastname: Tang
authors.forename: Lina
authors.initials: L
authors.lastname: Shihabuddin
authors.forename: Monte S
authors.initials: MS
authors.lastname: Buchsbaum
mesh_terms: D000328:Adult; D016880:Anisotropy; D001921:Brain / Q000033:anatomy & histology* / Q000473:pathology / Q000503:physiopathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005625:Frontal Lobe / Q000033:anatomy & histology / Q000473:pathology; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D012720:Severity of Illness Index