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Schizophrenia: head size correlates with 2nd Trimester markers
SATURDAY,, MAY 21
BIOL PSYCHIATRY
1994;35:615-747
ties in the hippocnmpal/amygdala complex, parahippoeampal gyms, and superior temporal gyms, mostly on the left side of the brain. MRI prorides the opportunity to noninvasively obtain images of the brain of living subjects, circumventing many of the problems with post-mortem studies, but foregoing the histological detail found in those studies, it is often difficult to reliably separate the hippocampal and amygdalar regions on conventional MR! scans. We here report preliminary efforts to develop a method for obtaining high resolution MR! scans of the hippocampal region in schizophrenic and control subjects. MR images were acquired on a 1.5 Tesla MR General Electric SIGNA System. The protocol consists of 15, 3ram coronal oblique slices with .35mm in-plane resolution through the temporal lobe region (TE-23, TR-3000, field of view- 18cm, phase encoding steps - 192, NEX-4). Only a few subjects have been run through this new protocol, but the resulting images have shown clear separation between the amygdala and the hippocampal formation on each slice.
388. FRONTAL AND TEMPORAL LOBE BRAIN VOLUMES IN SCHIZOPHRENIA: RELATIONSHIP TO SYMPTOMATOLOGY AND CLINICAL SUBTYPE B. Turetsky, P.E. Cowell, R.C. Gur, R.I. Grossman, & R.E. Gur University of Pennsylvania, Philadelphia, PA Clinical features of schizophrenia have been related to neuroanatomic measures with inconclusive results. Some MR! studies report volume deficits of the temporal lobes and specific temporal lobe structures. Other studies have failed to fred localized deficits, or have found diffuse abnormalities inconsistent with a specific localized structural change, in a large sample of patients and controls, we found abnormalities in whole-brain measures that differed according to the relative prominence of negative, Sclmeiderian, and paranoid symptoms. We now examine left and right frontal and temporal lobe volumes, and their relationship to clinical symptomatology. Subjects were 71 schizophrenics and 77 controls. Scores on the SANS, SAPS and BPRS were used to classify patients as Negative, Paranoid, and Sclmeiderian subtypes. Patients were also divided into Def. icit vs. Non-Deficit. Transaxial spin-echo MR! images (TR-3000, TE-30 and 80 msec) were obtained. Region-of-Interest (ROD boundaries, representing left and right frontal and temporal lobes were identified in collaboration with a neuroradiologist. Brain and CSF volumes were obtained separately for each ROI, using a semi-antomated segmentation algorithm. Reliability of measurement across two independent investigators ranged from 0.96 to 0.98 for brain, and from 0.88 to 0.99 for CSF. Schizophrenics had insignificantly smaller brain volumes across all regions. There was a significant diagnosis by region by hemisphere interaction. Schizophrenics exhibited abnormalities of brain asymmetry characterized by relatively greater decreases in size of the left temporal and right frontal lobes, independent of age, sex and overall brain size. Temporal lobe asymmetry was associated with severity of negative symptoms, while abnormal frontal lobe asymmetry was associated with duration of illness. Deficit patients had a region-specific increase in left temporal CSF. Similarly, Negative schizophrenics had greater left temporal CSF, while Schneiderian patients had more CSF in both left and right temporal lobes. Paranoid patients were not different from controls on these measures. These results suggest that regional patterns of neuroanatomic abnormalities are not uniform across schizophrenic subgroups. They thus provide clues to differences in underlying pathophysiology ~n different patient subgroups.
723
389. PSYCHIATRIC SEQUELAE OF LOW BIRTH WEIGHT AT 6 YEARS OF AGE Naomi Breslau Henry Ford Health Sciences Center, Detroit, MI 48202; University of Michigan School of Medicine, Ann Arbor, MI Recent studies have reported an increased prevalence of behavior problems in very low birthweight children (VLBW) (_100had no increased odds in either site. Suburban LBW children with milder cognitive deficits might be protected from adverse behavioral sequelae by the advantages provided to children in middle-class households, a protection that might not extend to LBW children with more severe cognitive deficits.
390. SCHIZOPHRENIA: HEAD SIZE CORRELATES WITH 2nd TRIMESTER MARKERS H. S. Bracha I, J.W. Gilger I, D.S. McCray t, E.F. Torrey2, & C.N. Karson t tPsychiatry, University of Arkansas for Medical Sciences, Slot O 554,4301 West Markham, Little Rock, AR 72205; 2NIMH We examined the relationship between markers of second-trimester-prenatal insult (inutem, non-shared environment) and head circumference in twin pairs discordant for schizophrenia. Twenty-one pairs of monozygotic (MZ) twins, where one member of each pair was schizophrenic, served as subjects. The two major variables of this study were: the "percent absolute within-pair difference in total finger ridge count" (%ad-TFRC), and the "percent signed within-pair difference in head circumference" (%sdHC). A significant relationship between %ad-TFRC and %ad-HC was found: Pearson r - -.89 (p<.001). These data are in line with our prediction: that there is a significant tendency for the psychotic twins to have smaller head circumferences than their non-psychotic cotwins as member's of the twin pairs vary increasingly in finger ridge counts i.e., as there are increasing differential second-trimester effects [in-utero, non-shared environment] on members of the same twin pair. The results suggest that the within-pair differences in head circumference in MZ twins discordant for schizophrenia may in part be a consequence of differential within-pair prenatal insult occurring around the second trimester since dermal ridges examined in this study are known to develop at that time. - Supported by a DVA grant to H.S. Bracha, M.D.
BIOL PSYCHIATRY
1994;35:615-747
ties in the hippocnmpal/amygdala complex, parahippoeampal gyms, and superior temporal gyms, mostly on the left side of the brain. MRI prorides the opportunity to noninvasively obtain images of the brain of living subjects, circumventing many of the problems with post-mortem studies, but foregoing the histological detail found in those studies, it is often difficult to reliably separate the hippocampal and amygdalar regions on conventional MR! scans. We here report preliminary efforts to develop a method for obtaining high resolution MR! scans of the hippocampal region in schizophrenic and control subjects. MR images were acquired on a 1.5 Tesla MR General Electric SIGNA System. The protocol consists of 15, 3ram coronal oblique slices with .35mm in-plane resolution through the temporal lobe region (TE-23, TR-3000, field of view- 18cm, phase encoding steps - 192, NEX-4). Only a few subjects have been run through this new protocol, but the resulting images have shown clear separation between the amygdala and the hippocampal formation on each slice.
388. FRONTAL AND TEMPORAL LOBE BRAIN VOLUMES IN SCHIZOPHRENIA: RELATIONSHIP TO SYMPTOMATOLOGY AND CLINICAL SUBTYPE B. Turetsky, P.E. Cowell, R.C. Gur, R.I. Grossman, & R.E. Gur University of Pennsylvania, Philadelphia, PA Clinical features of schizophrenia have been related to neuroanatomic measures with inconclusive results. Some MR! studies report volume deficits of the temporal lobes and specific temporal lobe structures. Other studies have failed to fred localized deficits, or have found diffuse abnormalities inconsistent with a specific localized structural change, in a large sample of patients and controls, we found abnormalities in whole-brain measures that differed according to the relative prominence of negative, Sclmeiderian, and paranoid symptoms. We now examine left and right frontal and temporal lobe volumes, and their relationship to clinical symptomatology. Subjects were 71 schizophrenics and 77 controls. Scores on the SANS, SAPS and BPRS were used to classify patients as Negative, Paranoid, and Sclmeiderian subtypes. Patients were also divided into Def. icit vs. Non-Deficit. Transaxial spin-echo MR! images (TR-3000, TE-30 and 80 msec) were obtained. Region-of-Interest (ROD boundaries, representing left and right frontal and temporal lobes were identified in collaboration with a neuroradiologist. Brain and CSF volumes were obtained separately for each ROI, using a semi-antomated segmentation algorithm. Reliability of measurement across two independent investigators ranged from 0.96 to 0.98 for brain, and from 0.88 to 0.99 for CSF. Schizophrenics had insignificantly smaller brain volumes across all regions. There was a significant diagnosis by region by hemisphere interaction. Schizophrenics exhibited abnormalities of brain asymmetry characterized by relatively greater decreases in size of the left temporal and right frontal lobes, independent of age, sex and overall brain size. Temporal lobe asymmetry was associated with severity of negative symptoms, while abnormal frontal lobe asymmetry was associated with duration of illness. Deficit patients had a region-specific increase in left temporal CSF. Similarly, Negative schizophrenics had greater left temporal CSF, while Schneiderian patients had more CSF in both left and right temporal lobes. Paranoid patients were not different from controls on these measures. These results suggest that regional patterns of neuroanatomic abnormalities are not uniform across schizophrenic subgroups. They thus provide clues to differences in underlying pathophysiology ~n different patient subgroups.
723
389. PSYCHIATRIC SEQUELAE OF LOW BIRTH WEIGHT AT 6 YEARS OF AGE Naomi Breslau Henry Ford Health Sciences Center, Detroit, MI 48202; University of Michigan School of Medicine, Ann Arbor, MI Recent studies have reported an increased prevalence of behavior problems in very low birthweight children (VLBW) (_
390. SCHIZOPHRENIA: HEAD SIZE CORRELATES WITH 2nd TRIMESTER MARKERS H. S. Bracha I, J.W. Gilger I, D.S. McCray t, E.F. Torrey2, & C.N. Karson t tPsychiatry, University of Arkansas for Medical Sciences, Slot O 554,4301 West Markham, Little Rock, AR 72205; 2NIMH We examined the relationship between markers of second-trimester-prenatal insult (inutem, non-shared environment) and head circumference in twin pairs discordant for schizophrenia. Twenty-one pairs of monozygotic (MZ) twins, where one member of each pair was schizophrenic, served as subjects. The two major variables of this study were: the "percent absolute within-pair difference in total finger ridge count" (%ad-TFRC), and the "percent signed within-pair difference in head circumference" (%sdHC). A significant relationship between %ad-TFRC and %ad-HC was found: Pearson r - -.89 (p<.001). These data are in line with our prediction: that there is a significant tendency for the psychotic twins to have smaller head circumferences than their non-psychotic cotwins as member's of the twin pairs vary increasingly in finger ridge counts i.e., as there are increasing differential second-trimester effects [in-utero, non-shared environment] on members of the same twin pair. The results suggest that the within-pair differences in head circumference in MZ twins discordant for schizophrenia may in part be a consequence of differential within-pair prenatal insult occurring around the second trimester since dermal ridges examined in this study are known to develop at that time. - Supported by a DVA grant to H.S. Bracha, M.D.