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II. Structural Brain Characteristics of Schizophrenia and Schizotypal Personality Disorder

Tyrone D. Cannon, PhD; Sarnoff A. Mednick, PhD, DrMed; Josef Parnas, MD; Fini Schulsinger, MD; Johannes Praestholm, MD; Aage Vestergaard, MD

Arch Gen Psychiatry. 1994;51(12):955-962.

Abstract
Background
We examined differences in ventricular and sulcal cerebrospinal fluid-to-brain ratios as a function of lifetime psychiatric diagnosis in the offspring of schizophrenic mothers (high-risk sample) and in the offspring of normal parents (low-risk sample).

Methods
We used a cohort analytic study of 17 highrisk individuals with schizophrenia, 31 high-risk individuals with schizotypal personality disorder, 33 highrisk individuals with nonschizophrenia-spectrum psychiatric disorders, 45 high-risk individuals with no disorders, 31 low-risk individuals with psychiatric disorders of all types, and 46 low-risk individuals with no disorders, evaluated initially in 1962 when they were a mean age of 15 years, and reexamined from 1986 through 1989 with psychiatric interviews and computed tomographic scans of the brain.

Results
High-risk individuals with schizophrenia and schizotypal personality disorder evidenced an equivalent degree of cortical sulcal enlargement, and both groups evidenced significantly greater sulcal enlargement than did highrisk individuals with nonschizophrenia-spectrum disorders and no disorders and low-risk individuals with psychiatric disorders and no disorders. High-risk individuals with schizophrenia evidenced significantly greater ventricular enlargement than did high-risk and low-risk subjects with other disorders and no disorders, including those with schizotypal personality disorder. These differences were independent of age, gender, history of substance dependence, and history of organic brain syndromes and head injuries.

Conclusions
Among the offspring of schizophrenic parents, cortical abnormalities are expressed equally across the range of syndromes in the schizophrenia spectrum. Subcortical abnormalities (ie, ventricular enlargement) are more pronounced in the more severe syndrome (ie, schizophrenia).

Author Affiliations
From the Departments of Psychology and Psychiatry, University of Pennsylvania, Philadelphia (Dr Cannon); the Social Science Research Institute, University of Southern California, Los Angels (Dr Mednick); and the Institute of Preventive Medicine, Copenhagen Health Services, Kommunehospitalet (Drs Parnas and Schulsiner), and Departments of Psychiatry (Drs Parnas and Schulsinger) and Diagnostic Radiology (Drs Praestholm and Vestergaard), Hvidovre Hospital, Copenhagen, Denmark.

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