Background
Elderly schizophrenia patients frequently develop cognitive impairment of unclear
etiology. Magnetic resonance imaging (MRI) studies revealed brain structural abnormalities,
but the pattern of cortical gray matter (GM) volume and its relationship with cognitive
and behavioral symptoms are unknown.
Methods
Magnetic resonance scans were taken from elderly schizophrenia patients (n = 20, age 67 ± 6 SD, Mini-Mental State Examination [MMSE] 23 ± 4), Alzheimer's disease
(AD) patients (n = 20, age 73 ± 9, MMSE 22 ± 4), and healthy elders (n = 20, age 73 ± 8, MMSE 29 ± 1). Patients were assessed with a comprehensive neuropsychological
and behavioral battery. Cortical pattern matching and a region-of-interest analysis,
based on Brodmann areas (BAs), were used to map three-dimensional (3-D) profiles of
differences in patterns of gray matter volume among groups.
Results
Schizophrenia patients had 10% and 11% lower total left and right GM volume than healthy
elders (p < .001) and 7% and 5% more than AD patients (p = .06 and ns). Regions that had both significantly less gray matter than control
subjects and gray matter volume as low as AD mapped to the cingulate gyrus and orbitofrontal
cortex (BA 30, 23, 24, 32, 25, 11). The strongest correlate of gray matter volume
in elderly schizophrenia patients, although nonsignificant, was the positive symptom
subscale of the Positive and Negative Syndrome Scale, mapping to the right anterior
cingulate area (r = .42, p = .06).
Conclusions
The orbitofrontal/cingulate region had low gray matter volume in elderly schizophrenia
patients. Neither cognitive impairment nor psychiatric symptoms were significantly
associated with structural differences, even if positive symptoms tended to be associated
with increased gray matter volume in this area.
Key Words
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Article info
Publication history
Published online: May 04, 2009
Accepted:
February 19,
2009
Received in revised form:
January 22,
2009
Received:
August 27,
2008
Identification
Copyright
© 2009 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
