The project on structural brain imaging investigates structural pathology of the brains of schizophrenic patients housed in the William A. White research units using x-ray computerized tomography (CT). Patients are compared to matched normal controls. The most recent study, a culmination of four years of data collection, compared 73 schizophrenic patients to 30 normal volunteer controls. This project is a replication and extension of the previous work done in this area in the branch. Using standardized techniques four brain areas were examined: Lateral ventricles, third ventricles, cortical (parieto-occipital) areas, and prefrontal cortex. In this sample, the lateral and third ventricles continued to be significantly larger in patients than controls. A potentially exciting new findings was that though there was essentially no differences between patients and controls in cortical atrophy in the parieto occipital distribution, the schizophrenic patients showed substantially greater atrophy in the prefrontal distribution, localizing the cortical changes to this area. Further, in a subgroup of 18 drug-free and 22 medicated patients, the CT abnormalities were correlated with regional cerebral blood flow (rCBF) using the radioactive 133 Xenon inhalation technique. Relationships were found between the neurophysiological measurements and CT scanning, especially in the prefrontal cortex and ventricular areas. This work is being amplified to search for clinical and biological correlations of ventricular enlargement and prefrontal atrophy, particularly with respect to other signs of prefrontal pathology, e.g. rCBF, EEG, PET data. In addition, we followed up earlier patients, rescanning them after 9-9 years. We have found no change over time, indicating that the pathology underlying these changes is probably static.
