Elsevier

Biological Psychiatry

Volume 58, Issue 6, 15 September 2005, Pages 457-467
Biological Psychiatry

Original article
The Relationship of Structural Alterations to Cognitive Deficits in Schizophrenia: A Voxel-Based Morphometry Study

https://doi.org/10.1016/j.biopsych.2005.04.036Get rights and content

Background

Region of interest studies have identified a number of structure-cognition associations in schizophrenia and revealed alterations in structure-cognition relationship in this population.

Methods

We examined the relationship of structural brain alterations, identified using voxel-based morphometry, to cognitive deficits in 45 schizophrenia patients relative to 43 healthy control subjects and tested the hypothesis that structure-cognition relationship is altered in schizophrenia.

Results

Patients had smaller total brain, gray matter, and white matter volumes. Regional alterations were left-hemisphere specific, including: gray matter reduction of inferior frontal, lingual, and anterior superior temporal gyri; white matter reduction of posterior and occipital lobes; and gray matter increase of the putamen and the precuneus. Smaller whole brain and gray matter volumes were associated with lower premorbid intelligence quotient (IQ) and poorer performance on IQ-dependent cognitive measures in patients and to a similar extent in control subjects. Larger precuneus was associated with better immediate verbal memory in patients, whereas verbal and nonverbal memory were positively associated with inferior frontal gyrus volume in control subjects. Smaller occipital white matter volume was associated with slower information processing speed in patients but not in control subjects.

Conclusions

Regional volume alterations are associated with specific cognitive deficits in schizophrenia. Some structure-cognition relationships differentiate this population from healthy control subjects.

Section snippets

Participants

Fifty inpatients and outpatients diagnosed with schizophrenia or schizophrenia-related disorders by experienced psychiatrists using the Structured Clinical Interview for DSM-IV Axis I Disorders Research Version (SCID-I) (First et al 1996a) and 45 healthy control subjects were recruited. All participants were right-handed and between 18 and 65 years of age.

The exclusion criteria were 1) neurological conditions, head trauma with a loss of consciousness, previous experience with the current

Validation of Patient Sample

The inclusion of first-episode patients did not disturb the homogeneity of the patient sample.

Global Brain Volume Alterations

Patients had decreased global gray matter, white matter, and whole brain volumes (in liters). The gray matter volume was reduced by 9% (patients’ mean = .659, SD = .007; control subjects’ mean = .725, SD = .008) [F(1,84) = 13.956, p < .0001] beyond the significant confounding effects of age (p = .001) and sex (p < .0001). The white matter volume was reduced by 7% (patients’ mean = .384, SD = .006;

Discussion

Schizophrenia patients had reduced total brain (9.5%), gray matter (9%), and white matter (7%) volumes. The global tissue volume reduction is in agreement with previous findings (Shenton et al 2001). All regional alterations occurred in the left hemisphere, mostly affecting heteromodal association areas. Alterations of the left hemisphere in schizophrenia are found more consistently than that of the right (Shenton et al 2001). Reveley et al (1987) reported the left hemisphere to be less dense

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