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Progressive Brain Changes in the Early Stage of Schizophrenia: A Combined Structural MRI and DTI Study

Author(s): Qiong Xiang, Yingchan Wang, Jianye Zhang, Yao Li, Zeping Xiao, Kaida Jiang, Yifeng Xu, Xiaoduo Fan, Zheng Wang, Dengtang Liu


Purpose: The developmental trajectory of brain structure in the early stage of schizophrenia has not been well defined. In this study, structural MRI and diffusion tensor imaging (DTI) were used to explore the brain gray matter (GM) and white matter (WM) changes in patients with schizophreniform disorder or early schizophrenia.

Methods: Sixteen schizophreniform patients, 19 early schizophrenia patients (duration of illness < 5 years) and 25 healthy controls were enrolled in this study. Structural MRI and DTI images were obtained. GM volumes were examined using voxel-based morphometry (VBM), and fractional anisotropy (FA) was used to measure WM integrity.

Results: Compared with healthy controls, GM volume was smaller in the right hippocampus and larger in the left middle frontal gyrus and right temporal gyrus in schizophreniform patients; there were no significant differences in FA values between the two groups. GM volumes were reduced in the right hippocampus, bilateral parahippocampal gyri, right middle temporal gyrus and precuneus, and left inferior occipital lobe, and increased in the left temporal lobe in schizophrenia patients compared with healthy controls; furthermore, FA values were reduced in the bilateral cingulate, right insular cortex, precuneus and superior frontal gyrus, and increased in the bilateral fusiform gyri, right superior temporal gyrus, right middle frontal lobe of schizophrenia patients compared with healthy controls.

Conclusion: Our study suggests that brain GM and WM abnormalities occur in early stage schizophrenia, with the occurrence of GM changes, particularly those in the right hippocampus, likely preceding changes in WM.

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