Schizophrenia Bulletin Advance Access originally published online on August 28, 2007
Schizophrenia Bulletin 2008 34(2):393-401; doi:10.1093/schbul/sbm097
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Patterns of Structural MRI Abnormalities in Deficit and Nondeficit Schizophrenia
2 Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138 Naples, Italy
3 Biostructure and Bioimaging Institute, CNR and Diagnostic Imaging, University Federico II, Naples, Italy
4 Department of Psychiatry, Neurobiology, Pharmacology and Biotechnologies, University of Pisa, Italy
5 Department of Psychiatry, University of Milan, Italy
6 Department of Experimental Medicine, University of L'Aquila, Italy
7 Department of Mental Health, University of Brescia, Italy
8 Department of Psychiatry, Harvard University, Boston, MA
1 To whom correspondence should be addressed; tel: +39-081-5666504 fax: +39-081-5666523, e-mail: sgalderi{at}tin.it.
Negative symptoms of schizophrenia have generally been found in association with ventricular enlargement and prefrontal abnormalities. These relationships, however, have not been observed consistently, most probably because negative symptoms are heterogeneous and result from different pathophysiological mechanisms. The concept of deficit schizophrenia (DS) was introduced by Carpenter et al to identify a clinically homogeneous subgroup of patients characterized by the presence of primary and enduring negative symptoms. Findings of brain structural abnormalities reported by magnetic resonance imaging (MRI) studies focusing on DS have been mixed. The present study included 34 patients with DS, 32 with nondeficit schizophrenia (NDS), and 31 healthy comparison subjects, providing the largest set of MRI findings in DS published so far. The Schedule for the Deficit Syndrome was used to categorize patients as DS or NDS patients. The 2 patient groups were matched on age and gender and did not differ on clinical variables, except for higher scores on the negative dimension and more impaired interpersonal relationships in DS than in NDS subjects. Lateral ventricles were larger in NDS than in control subjects but were not enlarged in patients with DS. The cingulate gyri volume was smaller in NDS but not in DS patients as compared with healthy subjects. Both groups had smaller dorsolateral prefrontal cortex and temporal lobes than healthy subjects, but DS patients had significantly less right temporal lobe volume as compared with NDS patients. These findings do not support the hypothesis that DS is the extreme end of a severity continuum within schizophrenia.
Keywords: primary negative symptoms / lateral ventricles / temporal lobes / dorsolateral prefrontal cortex / cingulate gyri