This research is intended to capitalize on the wealth of data already collected on a large group of patients with schizophrenia and healthy volunteers. These subjects were scanned twice over a 4-7 year period with high-resolution MRI for anatomical brain images and with duffusion-tensor imaging sequence for the visualization of white matter tracts. The resulting set of data is unique in that it provides detailed information not only on brain structure, but also on the white matter connections between various regions of the brain and their changes over an approximately 5-year period. To the best of our knowledge, no longitudinal studies of white matter tracts in patients with schizophrenia have ever yet been published. Moreover, patients with schizophrenia in the proposal were divided into those with good outcomes to their illness (i.e. capable of independent living) and those with very poor outcomes, who are unable to care for themselves or obtain basic necessities of life such as food, clothing, and shelter. Patients with this type of poor-outcome illness constitute the vast majority of chronically institutionalized inpatients in the state psychiatric hospitals. We plan to analyze this dataset in detail, specifically evaluating the course and progression of gray and white matter deficits over the 5-year period in schizophrenia patients with good and poor outcomes. Understanding the differences in disease progression in these two groups of patients is the key for better delineation of the poor-outcome subtype of schizophrenia. It may potentially lead to early diagnosis of this very severe subtype of the illness and to the development of early pharmacological interventions aimed at prevention of disease progression, hence - chronic institutionalization of these patients. ? ? ?
