Three-dimensional laser surface imaging and geometric morphometrics resolve frontonasal dysmorphology in schizophrenia.
BACKGROUND
Although a role for early developmental disturbance(s) in schizophrenia is postulated, it has proved difficult to identify hard, biological evidence. The brain and face emerge in embryologic intimacy, such that in neurodevelopmental disorders, brain dysmorphogenesis is accompanied by facial dysmorphogenesis.


METHODS
Three-dimensional (3D) laser surface imaging was used to capture the facial surface of patients and control subjects in 37 male and 32 female patients who satisfied DSM-IV criteria for schizophrenia in comparison with 58 male and 34 female control subjects. Surface images were analyzed using geometric morphometrics and 3D visualizations to identify domains of facial shape that distinguish patients from control subjects.


RESULTS
Both male and, particularly, female patients evidenced significant facial dysmorphology. There was narrowing and reduction of the mid to lower face and frontonasal prominences, including reduced width and posterior displacement of the mouth, lips, and chin; increased width of the upper face, mandible, and skull base, with lateral displacement of the cheeks, eyes, and orbits; and anterior displacement of the superior margins of the orbits.


CONCLUSIONS
The frontonasal prominence, which enjoys the most intimate embryologic relationship with the anterior brain and also orchestrates aspects of development in maxillary and mandibular domains, evidences a characteristic topography of dysmorphogenesis in schizophrenia.
Hennessy
Robin J
RJ
Stanley Research Unit, Molecular and Cellular Therapeutics and RCSI Research Institute, Royal College of Surgeons in Ireland, Dublin.
Baldwin
Patrizia A
PA
Browne
David J
DJ
Kinsella
Anthony
A
Waddington
John L
JL
D000328:Adult; D002508:Cephalometry; D019465:Craniofacial Abnormalities / Q000175:diagnosis*; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007834:Lasers; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000002:abnormalities; D012016:Reference Values; D012559:Schizophrenia / Q000175:diagnosis*; D012737:Sex Factors