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A Postmortem Study and a Proposal Concerning the Genetic Basis of the Disease

Timothy J. Crow, PhD, FRCP, FRCPsych; Joanna Ball, MD, MRCP; Steven R. Bloom, MD, FRCP; Rosemary Brown; Clive J. Bruton, MD; Nigel Colter; Christopher D. Frith, PhD; Eve C. Johnstone, MD, FRCP, FRCPsych; David G. C. Owens, MD, FRCP, FRCPych; Gareth W. Roberts, PhD
From the Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, England (Drs Crow, Frith, Johnstone, Owens, and Roberts and Mr Colter); the Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England (Drs Ball and Bloom); and the Department of Neuropathology, Runwell Hospital, Wickford, England (Ms Brown and Dr Bruton).

Arch Gen Psychiatry. 1989;46(12):1145-1150.

Abstract
• Schizophrenia is associated with structural changes (eg, a mild degree of ventricular enlargement) in the brain, although whether these precede onset of illness or progress with episodes is not established. In a postmortem study, we find that ventricular enlargement affects the posterior and particularly the temporal horn of the lateral cerebral ventricle. By comparison with controls and with patients suffering from Alzheimer-type dementia (in which there is also temporal horn enlargement), the change is highly significantly selective to the left hemisphere. This deviation was not accompanied by an increase in glial cell number (examined chemically by assay of diazepam-binding inhibitor immunoreactivity and microscopically by density of staining with the Holzer' technique). The findings are consistent with the view that schizophrenia is a disorder of the genetic mechanisms that control the development of cerebral asymmetry.

Footnotes
Accepted for publication September 22, 1989.

Presented as a poster exhibit at the Fourth European Winter Workshop on Schizophrenia, Badgastein, Austria, January, 1988.

Reprint requests to Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Harrow, United Kingdom HAI 3UJ (Dr Crow).

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