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Relationship to Negative Symptoms

Michael Sanfilipo, MS; Todd Lafargue, MD; Henry Rusinek, PhD; Luigi Arena, MD, PhD; Celia Loneragan, MA; Andrew Lautin, MD; Deborah Feiner, BA; John Rotrosen, MD; Adam Wolkin, MD

Arch Gen Psychiatry. 2000;57:471-480.

Background  Previous research has provided evidence for brain abnormalities in schizophrenia, but their relationship to specific clinical symptoms and syndromes remains unclear.

Methods  With an all-male demographically similar sample of 53 schizophrenic patients and 29 normal control subjects, cerebral gray and white matter volumes (adjusted for intracranial volume and age) were determined for regions in the prefrontal lobe and in the superficial and mesial temporal lobe using T1-weighted magnetic resonance imaging with 2.8-mm coronal slices.

Results  As a group, schizophrenic patients had widespread bilateral decrements in gray matter in the prefrontal (7.4%) and temporal lobe regions (8.9%), but not in white matter in these regions. In the temporal lobe, gray matter reductions were found bilaterally in the superior temporal gyrus (6.0%), but not in the hippocampus and parahippocampus. While there were no overall group differences in white matter volumes, widespread decrements in prefrontal white matter in schizophrenic patients (n=53) were related to higher levels of negative symptoms (partial r[49]=-0.42, P=.002), as measured by the Scale for the Assessment of Negative Symptoms. A post hoc analysis revealed that schizophrenic patients with high negative symptoms had generalized prefrontal white matter reductions (11.4%) that were most severe in the orbitofrontal subregion (15.1%).

Conclusions  These results suggest that gray matter deficits may be a fairly common structural abnormality of schizophrenia, whereas reductions in prefrontal white matter may be associated with schizophrenic negative symptoms.

From the Psychiatry Service (Mr Sanfilipo, Ms Loneragan, and Drs Lautin, Rotrosen, and Wolkin) and the Radiology Service and Magnetic Resonance Imaging Section (Dr Arena), New York Veterans Affairs Medical Center, Departments of Psychiatry (Mr Sanfilipo, Dr Lafargue, Mss Loneragan and Feiner, and Drs Lautin, Rotrosen, and Wolkin) and Radiology (Drs Rusinek and Arena), New York University School of Medicine and the Departments of Psychiatry (Dr Lafargue) and Radiology (Dr Arena), Bellevue Hospital Center, New York, NY.

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