Brain structure differences among male schizophrenic patients with history of serious violent acts: an MRI voxel-based morphometric study.
The biological underpinnings of serious violent behaviors in patients with schizophrenia remain unclear. The aim of this study was to identify the characteristics of brain morphometry in patients with schizophrenia and a history of serious violent acts, who were being treated under relatively new legislation for offenders with mental illness in Japan where their relevant action should be strongly associated with their mental illness. We also investigated whether morphometric changes would depend on types of serious violent actions or not.



Thirty-four male patients with schizophrenia who were hospitalized after committing serious violent acts were compared with 23 male outpatients or inpatients with schizophrenia and no history of violent acts. T1-weighted magnetic resonance imaging (MRI) with voxel-based morphometry was used to assess gray matter volume. Additionally, patients with violent acts were divided based on whether their relevant actions were premeditated or not. The regional volumes of these two groups were compared to those of the control patient group.



Patients with schizophrenia and a history of serious violent acts showed significantly smaller regional volumes of the right inferior temporal area expanded to the middle temporal gyrus and the temporal pole, and the right insular area compared to patients without a history of violence. Patients with premeditated violent acts showed significantly smaller regional volumes of the right inferior temporal area, the right insular area, the left planum polare area including the insula, and the bilateral precuneus area including the posterior cingulate gyrus than those without a history of violence, whereas patients with impulsive violent acts showed significantly smaller volumes of only the right inferior temporal area compared to those without a history of violence.



Patients with schizophrenia and a history of serious violent acts showed structural differences in some brain regions compared to those with schizophrenia and no history of violence. Abnormalities in the right inferior temporal area were relatively common but did not depend on whether the violent actions were premeditated or not, and abnormalities in a wider range may be attributed to not only planning the violent action against others but also to maintaining that plan.



UMIN.ac.jp UMIN000008065 . Registered 2012/05/31.
Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan. nkuroki-tky@umin.ac.jp.|Department of Psychiatry, Saitama Medical University, 38 Morohongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan. nkuroki-tky@umin.ac.jp.|Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, 2-1-1 Kamikitazawa, Setagaya-ku, Tokyo, 156-0057, Japan. nkuroki-tky@umin.ac.jp.
Noriomi
0000-0003-1281-9307
N
Kuroki
Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.
Hiroko
H
Kashiwagi
Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8502, Japan.
Miho
M
Ota
Department of Social Welfare Services, Faculty of Human Science, Mejiro University, 4-31-1 Nakaochiai, Shinjuku-ku, Tokyo, 161-8539, Japan.
Masanori
M
Ishikawa
Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8502, Japan.
Hiroshi
H
Kunugi
Department of Radiology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.
Noriko
N
Sato
Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.
Naotsugu
N
Hirabayashi
Department of Psychiatry, Saitama Medical University, 38 Morohongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
Toshio
T
Ota
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D001931:Brain Mapping / Q000379:methods; D016022:Case-Control Studies; D003134:Commitment of Persons with Psychiatric Disorders; D066128:Gray Matter / Q000000981:diagnostic imaging; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007564:Japan; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology; D012559:Schizophrenia / Q000000981:diagnostic imaging*; D012565:Schizophrenic Psychology; D014754:Violence / Q000523:psychology*
MRI voxel-based morphometry; Premeditation; Schizophrenia; Violent acts