title: Cerebral grey, white matter and csf in never-medicated, first-episode schizophrenia.
abstract: We report the first voxel-based morphometric (VBM) study to examine cerebral grey and white matter and cerebrospinal fluid (CSF) using computational morphometry in never-medicated, first-episode psychosis (FEP). Region-of-interest (ROI) analysis was also performed blind to group membership. 26 never-medicated individuals with FEP (23 with DSM-IV schizophrenia) and 38 healthy controls had MRI brain scans. Groups were balanced for age, sex, handedness, ethnicity, paternal socio-economic status, and height. Healthy controls were recruited from the local community by advertisement. Grey matter, white matter, and CSF: global brain volume ratios were significantly smaller in patients. Patients had significantly less grey matter volume in L and R caudate nuclei, cingulate gyri, parahippocampal gyri, superior temporal gyri, cerebellum and R thalamus, prefrontal cortex. They also had significantly less white matter volume in the R anterior limb of the internal capsule fronto-occipital fasciculus and L and R fornices, and significantly greater CSF volume especially in the R lateral ventricle. Excluding the 3 subjects with brief psychotic disorder did not alter our results. Our data suggest that fronto-temporal and subcortical-limbic circuits are morphologically abnormal in never-medicated, schizophrenia. ROI analysis comparing the schizophrenia group (n=23) with the healthy controls (n=38) confirmed caudate volumes were significantly smaller bilaterally by 11%, and lateral ventricular volume was significantly larger on the right by 26% in the patients. Caudate nuclei and lateral ventricular volume measurements were uncorrelated (Pearson correlation coefficient 0.30, p=0.10), ruling out the possibility of segmentation artefact. Ratio of lateral ventricle to caudate volume was bilaterally significantly increased (p<0.005, 2-tailed), which could represent an early biomarker in first-episode, never-medicated schizophrenia.
authors.affiliation: Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, S.A.R. China. sechua@hku.hk
authors.forename: Siew E
authors.initials: SE
authors.lastname: Chua
authors.forename: Charlton
authors.initials: C
authors.lastname: Cheung
authors.forename: Vinci
authors.initials: V
authors.lastname: Cheung
authors.forename: Jack T K
authors.initials: JT
authors.lastname: Tsang
authors.forename: Eric Y H
authors.initials: EY
authors.lastname: Chen
authors.forename: Jason C H
authors.initials: JC
authors.lastname: Wong
authors.forename: Jason P Y
authors.initials: JP
authors.lastname: Cheung
authors.forename: Lawrance
authors.initials: L
authors.lastname: Yip
authors.forename: Kin-Shing
authors.initials: KS
authors.lastname: Tai
authors.forename: John
authors.initials: J
authors.lastname: Suckling
authors.forename: Gráinne M
authors.initials: GM
authors.lastname: McAlonan
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology*; D002421:Caudate Nucleus / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology; D002552:Cerebral Ventricles / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000502:physiology*; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D020547:Lateral Ventricles / Q000473:pathology; D008032:Limbic System / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009415:Nerve Net / Q000473:pathology; D011569:Psychiatric Status Rating Scales; D012016:Reference Values; D012559:Schizophrenia / Q000175:diagnosis*