Background
It is well established that schizophrenia is associated with structural brain abnormalities,
but whether these are static or progress over time remains controversial.
Methods
A systematic review of longitudinal volumetric studies using region-of-interest structural
magnetic resonance imaging in patients with schizophrenia and healthy control subjects.
The percentage change in volume between scans for each brain region of interest was
obtained, and data were combined using random effects meta-analysis.
Results
Twenty-seven studies were included in the meta-analysis, with 928 patients and 867
control subjects, and 32 different brain regions of interest. Subjects with schizophrenia
showed significantly greater decreases over time in whole brain volume, whole brain
gray matter, frontal gray and white matter, parietal white matter, and temporal white
matter volume, as well as larger increases in lateral ventricular volume, than healthy
control subjects. The time between baseline and follow-up magnetic resonance imaging
scans ranged from 1 to 10 years. The differences between patients and control subjects
in annualized percentage volume change were −.07% for whole brain volume, −.59% for
whole brain gray matter, −.32% for frontal white matter, −.32% for parietal white
matter, −.39% for temporal white matter, and +.36% for bilateral lateral ventricles.
Conclusions
These findings suggest that schizophrenia is associated with progressive structural
brain abnormalities, affecting both gray and white matter. We found no evidence to
suggest progressive medial temporal lobe involvement but did find evidence that this
may be partly explained by heterogeneity between studies in patient age and illness
duration. The causes and clinical correlates of these progressive brain changes should
now be the focus of investigation.
Key Words
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Article info
Publication history
Published online: April 04, 2011
Accepted:
January 22,
2011
Received in revised form:
January 21,
2011
Received:
October 28,
2010
Identification
Copyright
© 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
