Reduced paralimbic system gray matter volume in schizophrenia: Correlations with clinical variables, symptomatology and cognitive function.
BACKGROUND
Psychopathy is associated with dysfunction in regions that compose the paralimbic system, such as the orbitofrontal cortex (OFC), insular cortex (IC), temporal pole (TP), parahippocampal gyrus (PHG) and cingulate cortex (CC). However, findings of structural alterations in these regions are inconsistent in schizophrenia, and correlations between paralimbic system measures and symptomatology and cognitive function have not been investigated.


METHODS
93 patients with schizophrenia and 99 healthy controls received structural magnetic resonance imaging and clinical and cognitive assessment. We compared gray matter volume (GMV) between the two groups using voxel-based morphometry, and evaluated correlations between abnormal GMVs and clinical variables, symptomatology and cognitive function. The assessment of cognition included measures of processing speed, verbal fluency and memory.


RESULTS
Patients with schizophrenia demonstrated significant GMV decreases in the paralimbic system, including bilateral OFC, IC and TP (p < 0.05, FWE corrected). GMV decreases were also observed in bilateral superior temporal gyri (STG). The GMVs in bilateral OFC, left IC, left TP and bilateral STG were positively correlated with processing speed, and the GMVs in bilateral OFC were positively correlated with memory function in all participants. In our patient group, the GMV deficits were also associated with earlier age of onset, longer duration of illness, greater number of hospitalizations and more severe positive symptoms.


CONCLUSIONS
GMVs in the paralimbic system were significantly reduced in schizophrenia, and these abnormalities were correlated with clinical variables, symptomatology and cognitive function. These results suggest the paralimbic system plays an important role in the pathophysiology of schizophrenia.
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Jinmin
J
Liao
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Hao
H
Yan
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Qi
Q
Liu
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Jun
J
Yan
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Lanlan
L
Zhang
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Sisi
S
Jiang
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Xiao
X
Zhang
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Zheng
Z
Dong
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Wen
W
Yang
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Liwei
L
Cai
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Huining
H
Guo
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Yan
Y
Wang
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Zimeng
Z
Li
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China.
Lin
L
Tian
Peking University Sixth Hospital/Institute of Mental Health, 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; National Clinical Research Center for Mental Disorders and Key Laboratory for Mental Health, Ministry of Health (Peking University), 51 Hua Yuan Bei Road, Hai Dian District, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, 5 Yi He Yuan Road, Hai Dian District, Beijing 100871, China. Electronic address: daizhang@bjmu.edu.cn.
Dai
D
Zhang
Department of Psychiatry and Radiology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Shenyang 110001, Liaoning, China; Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA. Electronic address: fei.wang@yale.edu.
Fei
F
Wang
D000328:Adult; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications* / Q000473:pathology*; D013223:Statistics as Topic; D055815:Young Adult
Paralimbic system; Schizophrenia; Structural magnetic resonance imaging; Voxel-based morphometry