Academic journal article South African Journal of Psychiatry

Magnetic Resonance Imaging Study of Corpus Callosum Abnormalities in Patients with Different Subtypes of Schizophrenia

Academic journal article South African Journal of Psychiatry

Magnetic Resonance Imaging Study of Corpus Callosum Abnormalities in Patients with Different Subtypes of Schizophrenia

Article excerpt

The corpus callosum (CC) is known to be the largest white-matter fibre tract in the brain. It connects the two cerebral hemispheres and facilitates interhemispheric communication. [1,2] The CC has been strongly implicated as an anatomical mediator of dysfunctional interhemispheric transfer in schizophrenia[3] and a number of psychiatric disorders, including bipolar affective disorder, depression, [4] antisocial personality disorder, [5] post-traumatic stress disorder, [6] autism[7] and attention deficit hyperactivity disorder. [8]

Rosenthal and Bigelow[9] first drew attention to an increased thickness of the CC in postmortem brains of schizophrenia patients. Later, in neuroimaging studies, CC size was found to be increased, [10] decreased [11] or unaltered [12] compared with healthy controls. In a meta-analysis of 28 magnetic resonance imaging (MRI) studies carried out by Arnone et al., [13] they found that schizophrenia patients seem to show a reduction in CC area. [13]

The inconsistent findings may be a consequence of possible confounding factors, including age, [14] handedness, [15] gender, [16] chronicity of illness[17,18] and differences in CC partitioning schemes employed by the different studies. [19,20] In addition, it was suggested that it may also be owing to the heterogeneity in symptom profiles. [12,18] Schizophrenia is characterised by large heterogeneity, [12,18] and subtypes of schizophrenia may differ in neuroimaging-based measures of brain morphology. [21] Therefore, we planned to examine CC size on the basis of clinical subtype in schizophrenia, and we recruited the four subtypes of schizophrenia patients (paranoid, disorganised, undifferentiated and residual) who had different illness durations but were matched in age, sex and handedness. We hypothesised that the size of the CC may be different in the different subtypes of schizophrenia.

Objective

The objective of the current MRI study was to determine whether there were any differences in length and area of the CC among schizophrenia subtype patients and healthy subjects. Examining the association between schizophrenia subtypes and the size of the CC is likely to deepen our understanding of the pathophysiology of schizophrenia.

Methods

Patients

The study included 58 outpatients and inpatients with schizophrenia, comprising 44 males and 14 females (aged 18-50 years), who were seen in the Department of Psychiatry of Afyon Kocatepe University. All patients were diagnosed with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (text revised) (DSM-IV-TR)[22] on the basis of a clinical interview. Diagnosis of schizophrenia was established by two senior psychiatrists. Patients were divided into four groups according to DSM-IV-TR criteria: paranoid (n=17); disorganised (n=14); undifferentiated (n=20); and residual (n=7). The severity of psychotic symptoms was assessed using the positive and negative syndrome scale (PANSS), whose validity and reliability studies for the Turkish version were carried out by Kostakoglu et al. [23]

Controls

There were 31 normal healthy controls matched in age and sex (aged 23-62 years), comprising 22 males and 9 females, with no personal history of psychiatric illness or family history of psychosis, medical-neurological condition requiring regular medications or current exposure to psychotropic medications. They were screened with the non-patient version of the Structured Clinical Interview for DSM disorders (SCID).'24 Exclusion criteria

Exclusion criteria for both groups were left-handedness, concurrent or previous DSM-IVTR axis I disorder, a history of head trauma with loss of consciousness, a current medical illness (e.g. diabetes mellitus, hypertension or asthma) or known neurological disease, a lifetime history of substance dependence, or a history of any substance abuse or psychotic disorders in their first-degree relatives. …

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