Are cavum septum pellucidum abnormalities more common in schizophrenia spectrum disorders? A systematic review and meta-analysis.
Magnetic resonance imaging (MRI) studies have reported a variety of brain abnormalities in association with schizophrenia. These include a higher incidence of cavum septum pellucidum (CSP), which is consistent with a neurodevelopmental model for this disorder. In this meta-analytic review, we describe and discuss the main CSP MRI findings in schizophrenia spectrum disorders (SSDs) to date. We adopted as keywords cavum and schizophrenia or psychosis, and the inclusion criteria were articles in English, with samples of SSD patients compared to healthy subjects, which used MRI to assess CSP, without time limit. From 18 potential reports, fifteen were eligible to be part of the current review. These studies included 1054 patients with SSD and 866 healthy volunteers. Six out of 15 studies pointed to a higher prevalence of CSP of any size in SSD patients, while five out of 15 showed that subjects with SSD had a greater occurrence of a large CSP than healthy individuals. However, the meta-analysis demonstrated that only the incidence of a large CSP was significantly higher in SSD relative to healthy comparisons (odds ratio=1.59; 95%CI 1.07-2.38; p=0.02). Overall our results suggest that only a large CSP is associated with SSD while a small CSP may be considered a normal neuroanatomical variation. Our review revealed a large degree of variability in the methods employed across the MRI studies published to date, as well as evidence of publication bias. Studies in large, community-based samples with greater standardization of methods should clarify the true significance of CSP in SSD.
Department of Neuroscience and Behavior, Medical School, University of São Paulo (USP), Ribeirão Preto (SP), Brazil and INCT Translational Medicine, Brazil. clarissaf@hotmail.com
Clarissa
C
Trzesniak
Irismar R
IR
Oliveira
Matthew J
MJ
Kempton
Amanda
A
Galvão-de Almeida
Marcos H N
MH
Chagas
Maria Cecília F
MC
Ferrari
Alaor S
AS
Filho
Antonio W
AW
Zuardi
Daniel A
DA
Prado
Geraldo F
GF
Busatto
Phillip K
PK
McGuire
Jaime E C
JE
Hallak
José Alexandre S
JA
Crippa
D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D008279:Magnetic Resonance Imaging; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000473:pathology*; D012688:Septum Pellucidum / Q000473:pathology*