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Fornix Integrity and Hippocampal Volume in Male Schizophrenic Patients

  • Noriomi Kuroki
    Affiliations
    Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, Brockton, Massachusetts
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  • Marek Kubicki
    Affiliations
    Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, Brockton, Massachusetts
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  • Paul G. Nestor
    Affiliations
    Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, Brockton, Massachusetts
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  • Dean F. Salisbury
    Affiliations
    Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, Brockton, Massachusetts

    Department of Psychology, University of Massachusetts, Boston
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  • Hae-Jeong Park
    Affiliations
    Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, Brockton, Massachusetts
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  • James J. Levitt
    Affiliations
    Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, Brockton, Massachusetts
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  • Sophie Woolston
    Affiliations
    Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, Brockton, Massachusetts
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  • Melissa Frumin
    Affiliations
    Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, Brockton, Massachusetts
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  • Margaret Niznikiewicz
    Affiliations
    Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, Brockton, Massachusetts
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  • Carl-Fredrik Westin
    Affiliations
    Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, and Department of Radiology, Harvard Medical School, Boston, Massachusetts
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  • Stephan E. Maier
    Affiliations
    Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, and Department of Radiology, Harvard Medical School, Boston, Massachusetts
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  • Robert W. McCarley
    Affiliations
    Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, Brockton, Massachusetts

    Department of Psychology, University of Massachusetts, Boston

    Cognitive Neuroscience Laboratory, McLean Hospital, Belmont
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  • Martha E. Shenton
    Correspondence
    Address reprint requests to Dr. Martha E. Shenton, Psychiatry Neuroimaging Laboratory, 1249 Boylston Street, Boston, MA 02215
    Affiliations
    Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, Brockton, Massachusetts

    Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, and Department of Radiology, Harvard Medical School, Boston, Massachusetts
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      Background

      The hippocampus has been shown to be abnormal in schizophrenia. The fornix is one of the main fiber tracts connecting the hippocampus with other brain regions. Few studies have evaluated the fornix in schizophrenia, however. A focus on fornix abnormalities and their association with hippocampal abnormalities might figure importantly in our understanding of the pathophysiology of schizophrenia.

      Methods

      Line-scan diffusion tensor imaging (DTI) was used to evaluate diffusion in the fornix in 24 male patients with chronic schizophrenia and 31 male control subjects. Maps of fractional anisotropy (FA) and mean diffusivity (Dm), which are indices sensitive to white-matter integrity, were generated to quantify diffusion within the fornix. We used high spatial resolution magnetic resonance imaging (MRI) to measure hippocampal volume.

      Results

      FA and cross-sectional area of the fornix were significantly reduced in patients compared with control subjects. Dm was significantly increased, whereas hippocampal volume was bilaterally reduced in patients. Reduced hippocampal volume was correlated with increased mean Dm and reduced cross-sectional area of the fornix for patients. Patients also showed a significant correlation between reduced scores on neuropsychologic measures of declarative-episodic memory and reduced hippocampal volumes.

      Conclusions

      These findings demonstrate a disruption in fornix integrity in patients with schizophrenia.

      Key Words

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