December 1997

Structural Magnetic Resonance Imaging Abnormalities in Men With Severe Chronic Schizophrenia and an Early Age at Clinical Onset

Author Affiliations

From the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif (Drs Marsh, Harris, Lim, Beal, Faustman, and Sullivan and Ms DeMent); Psychiatry Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif (Dr Lim); the Biological Psychiatry Treatment and Research Unit, Napa State Hospital, Napa, Calif (Drs Harris, Beal, Hoff, and Minn); the Department of Psychiatry, Washington University School of Medicine, St Louis, Mo (Dr Csernansky); the Department of Psychiatry, University of California, San Francisco (Dr Harris); the Department of Psychiatry, University of California Davis School of Medicine (Dr Hoff); and SRI International, Menlo Park, Calif (Dr Pfefferbaum).

Arch Gen Psychiatry. 1997;54(12):1104-1112. doi:10.1001/archpsyc.1997.01830240060009

Background:  Early age at onset of schizophrenia often signifies a more severe form of the illness. However, the relationship between age at onset and brain abnormalities has not been established. We assessed temporal-limbic morphometry in severely ill men with chronic schizophrenia who had a relatively early onset of illness and examined the relationships among regional brain volumes, clinical symptoms, and age at illness onset.

Methods:  Temporal lobe, superior temporal gyrus, hippocampus, temporal horn, lateral ventricles, third ventricle, and frontoparietal volumes were measured on magnetic resonance imaging data from 56 schizophrenic men (mean [SD] age at illness onset, 16.6 [4.2] years) recruited from a state hospital and 52 age- and rangematched healthy control men.

Results:  Patients had significantly smaller gray matter volumes in the temporal lobe, superior temporal gyrus, and frontoparietal regions; smaller temporal lobe white matter volumes; and larger cerebrospinal fluid volumes for temporal lobe sulci and the 3 ventricular measures. There were no group differences in hippocampal volumes. Psychotic symptom subscores from the Brief Psychiatric Rating Scale were selectively correlated with smaller left posterior superior temporal gyrus gray matter volumes. None of the brain measurements were significantly correlated with age at illness onset.

Conclusions:  Data from this unique sample of severely ill schizophrenic men emphasize a pattern of structural abnormalities involving the cortex, but not the hippocampus, in schizophrenia. Furthermore, these data support theories suggesting that superior temporal gyrus abnormalities contribute selectively to psychotic symptoms and that the extent of structural abnormalities is unrelated to age of clinical symptom onset.