Structural MRI Differences between Patients with and without First Rank Symptoms: A Delusion?
OBJECTIVE
It has been suggested that specific psychotic symptom clusters may be explained by patterns of biological abnormalities. The presence of first rank symptoms (FRS) has been associated with cognitive abnormalities, e.g., deficits in self-monitoring or in the experience of agency, suggesting that a specific network of neural abnormalities might underlie FRS. Here, we investigate differences in cortical and subcortical brain volume between patients with and without FRS.


METHODS
Three independent patient samples (referred to as A, B, and C) with different mean ages and in different illness stages were included, leading to a total of 348 patients within the schizophrenia-spectrum. All underwent magnetic resonance imaging of the brain. In addition, the presence of FRS was established using a diagnostic interview. Patients with (FRS+, A: n = 63, B: n = 129, and C: n = 96) and without FRS (FRS-, A: n = 35, B: n = 17, and C: n = 8) were compared on global and local cortical volumes as well as subcortical volumes, using a whole brain (cerebrum) approach.


RESULTS
Nucleus accumbens volume was significantly smaller in FRS+ as compared with FRS- in sample A (p < 0.005). Furthermore, FRS+ showed a smaller volume of the pars-opercularis relative to FRS- in sample B (p < 0.001). No further significant differences were found in cortical and subcortical volumes between FRS+ and FRS- in either one of the three samples after correction for multiple comparison.


CONCLUSIONS
Brain volume differences between patients with and without FRS are, when present, subtle, and not consistent between three independent samples. Brain abnormalities related to FRS may be too subtle to become visible through structural brain imaging.
Department of Psychiatry, Academic Medical Centre , Amsterdam , Netherlands.
Henriette D
HD
Heering
Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands.
Godefridus J C
GJ
Koevoets
Department of Psychiatry, Academic Medical Centre , Amsterdam , Netherlands.
Laura
L
Koenders
Department of Psychiatry, Academic Medical Centre , Amsterdam , Netherlands.
Marise W J
MW
Machielsen
Department of Psychiatry, Academic Medical Centre , Amsterdam , Netherlands.
Carin J
CJ
Meijer
Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands.
Manabu
M
Kubota
Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands.
Jessica
J
de Nijs
Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands.
Wiepke
W
Cahn
Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands.
Hilleke E
HE
Hulshoff Pol
Department of Psychiatry, Academic Medical Centre , Amsterdam , Netherlands.
Lieuwe
L
de Haan
Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands.
Rene S
RS
Kahn
Brain Centre Rudolf Magnus, University Medical Centre Utrecht , Utrecht , Netherlands.
Neeltje E M
NE
van Haren
corticalvolumes; first rank symptoms; schizophrenia; structural MRI image analysis; subcortical volume