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. 1994 Apr;57(4):474–479. doi: 10.1136/jnnp.57.4.474

Clinical correlates of postmortem brain changes in schizophrenia: decreased brain weight and length correlate with indices of early impairment.

E C Johnstone 1, C J Bruton 1, T J Crow 1, C D Frith 1, D G Owens 1
PMCID: PMC1072879  PMID: 8163999

Abstract

From a postmortem study of the brains of 56 patients with schizophrenia and 56 controls, 38 cases whose clinical state had been objectively documented in life were examined to determine whether relations existed between features of the illness and postmortem findings. Decreased brain weight was significantly related (p < 0.05) to poor premorbid global function and to poor academic record, and decreased brain length was related to poorer premorbid global function (p < 0.05) and more severe negative symptoms. These relations are consistent with the view that morphological changes in the brain occur early in the course of the disease--that is, they are in some sense "developmental." An excess of "focal damage" in the patient group relative to controls was unrelated to the presence of morphological change or to features of illness, but was more common in female schizophrenic patients and was also correlated with evidence of cerebrovascular disease. This may possibly be due to a discrepancy between the groups in mode and cause of death.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brown R., Colter N., Corsellis J. A., Crow T. J., Frith C. D., Jagoe R., Johnstone E. C., Marsh L. Postmortem evidence of structural brain changes in schizophrenia. Differences in brain weight, temporal horn area, and parahippocampal gyrus compared with affective disorder. Arch Gen Psychiatry. 1986 Jan;43(1):36–42. doi: 10.1001/archpsyc.1986.01800010038005. [DOI] [PubMed] [Google Scholar]
  2. Bruton C. J., Crow T. J., Frith C. D., Johnstone E. C., Owens D. G., Roberts G. W. Schizophrenia and the brain: a prospective clinico-neuropathological study. Psychol Med. 1990 May;20(2):285–304. doi: 10.1017/s0033291700017608. [DOI] [PubMed] [Google Scholar]
  3. Crow T. J., Ball J., Bloom S. R., Brown R., Bruton C. J., Colter N., Frith C. D., Johnstone E. C., Owens D. G., Roberts G. W. Schizophrenia as an anomaly of development of cerebral asymmetry. A postmortem study and a proposal concerning the genetic basis of the disease. Arch Gen Psychiatry. 1989 Dec;46(12):1145–1150. doi: 10.1001/archpsyc.1989.01810120087013. [DOI] [PubMed] [Google Scholar]
  4. Cunningham Owens D. G., Johnstone E. C. The disabilities of chronic schizophrenia--their nature and the factors contributing to their development. Br J Psychiatry. 1980 Apr;136:384–395. doi: 10.1192/bjp.136.4.384. [DOI] [PubMed] [Google Scholar]
  5. Daniel D. G., Goldberg T. E., Gibbons R. D., Weinberger D. R. Lack of a bimodal distribution of ventricular size in schizophrenia: a Gaussian mixture analysis of 1056 cases and controls. Biol Psychiatry. 1991 Nov 1;30(9):887–903. doi: 10.1016/0006-3223(91)90003-5. [DOI] [PubMed] [Google Scholar]
  6. Feighner J. P., Robins E., Guze S. B., Woodruff R. A., Jr, Winokur G., Munoz R. Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry. 1972 Jan;26(1):57–63. doi: 10.1001/archpsyc.1972.01750190059011. [DOI] [PubMed] [Google Scholar]
  7. Ferrier I. N., Johnstone E. C., Crow T. J., Rincon-Rodriguez I. Anterior pituitary hormone secretion in chronic schizophrenics. Arch Gen Psychiatry. 1983 Jul;40(7):755–761. doi: 10.1001/archpsyc.1983.01790060053007. [DOI] [PubMed] [Google Scholar]
  8. Grove W. M., Lebow B. S., Medus C. Head size in relation to schizophrenia and schizotypy. Schizophr Bull. 1991;17(1):157–161. doi: 10.1093/schbul/17.1.157. [DOI] [PubMed] [Google Scholar]
  9. Harvey I., McGuffin P., Williams M., Toone B. K. The ventricle-brain ratio (VBR) in functional psychoses: an admixture analysis. Psychiatry Res. 1990 Apr;35(1):61–69. doi: 10.1016/0925-4927(90)90009-u. [DOI] [PubMed] [Google Scholar]
  10. Hounsfield G. N. Computerized transverse axial scanning (tomography). 1. Description of system. Br J Radiol. 1973 Dec;46(552):1016–1022. doi: 10.1259/0007-1285-46-552-1016. [DOI] [PubMed] [Google Scholar]
  11. Jakob H., Beckmann H. Prenatal developmental disturbances in the limbic allocortex in schizophrenics. J Neural Transm. 1986;65(3-4):303–326. doi: 10.1007/BF01249090. [DOI] [PubMed] [Google Scholar]
  12. Johnstone E. C., Crow T. J., Frith C. D., Husband J., Kreel L. Cerebral ventricular size and cognitive impairment in chronic schizophrenia. Lancet. 1976 Oct 30;2(7992):924–926. doi: 10.1016/s0140-6736(76)90890-4. [DOI] [PubMed] [Google Scholar]
  13. Johnstone E. C., Owens D. G., Bydder G. M., Colter N., Crow T. J., Frith C. D. The spectrum of structural brain changes in schizophrenia: age of onset as a predictor of cognitive and clinical impairments and their cerebral correlates. Psychol Med. 1989 Feb;19(1):91–103. doi: 10.1017/s0033291700011053. [DOI] [PubMed] [Google Scholar]
  14. Kovelman J. A., Scheibel A. B. A neurohistological correlate of schizophrenia. Biol Psychiatry. 1984 Dec;19(12):1601–1621. [PubMed] [Google Scholar]
  15. Krawiecka M., Goldberg D., Vaughan M. A standardized psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatr Scand. 1977 Apr;55(4):299–308. doi: 10.1111/j.1600-0447.1977.tb00174.x. [DOI] [PubMed] [Google Scholar]
  16. Owens D. G., Johnstone E. C., Crow T. J., Frith C. D., Jagoe J. R., Kreel L. Lateral ventricular size in schizophrenia: relationship to the disease process and its clinical manifestations. Psychol Med. 1985 Feb;15(1):27–41. doi: 10.1017/s0033291700020900. [DOI] [PubMed] [Google Scholar]
  17. Owens D. G., Johnstone E. C., Frith C. D. Spontaneous involuntary disorders of movement: their prevalence, severity, and distribution in chronic schizophrenics with and without treatment with neuroleptics. Arch Gen Psychiatry. 1982 Apr;39(4):452–461. doi: 10.1001/archpsyc.1982.04290040052008. [DOI] [PubMed] [Google Scholar]
  18. Pakkenberg B. Post-mortem study of chronic schizophrenic brains. Br J Psychiatry. 1987 Dec;151:744–752. doi: 10.1192/bjp.151.6.744. [DOI] [PubMed] [Google Scholar]
  19. Pearlson G. D., Kim W. S., Kubos K. L., Moberg P. J., Jayaram G., Bascom M. J., Chase G. A., Goldfinger A. D., Tune L. E. Ventricle-brain ratio, computed tomographic density, and brain area in 50 schizophrenics. Arch Gen Psychiatry. 1989 Aug;46(8):690–697. doi: 10.1001/archpsyc.1989.01810080020003. [DOI] [PubMed] [Google Scholar]
  20. Roberts G. W., Colter N., Lofthouse R., Bogerts B., Zech M., Crow T. J. Gliosis in schizophrenia: a survey. Biol Psychiatry. 1986 Sep;21(11):1043–1050. doi: 10.1016/0006-3223(86)90285-4. [DOI] [PubMed] [Google Scholar]
  21. Roberts G. W., Colter N., Lofthouse R., Johnstone E. C., Crow T. J. Is there gliosis in schizophrenia? Investigation of the temporal lobe. Biol Psychiatry. 1987 Dec;22(12):1459–1468. doi: 10.1016/0006-3223(87)90104-1. [DOI] [PubMed] [Google Scholar]
  22. Stevens J. R. Neuropathology of schizophrenia. Arch Gen Psychiatry. 1982 Oct;39(10):1131–1139. doi: 10.1001/archpsyc.1982.04290100011003. [DOI] [PubMed] [Google Scholar]
  23. Withers E., Hinton J. Three forms of the clinical tests of the sensorium and their reliability. Br J Psychiatry. 1971 Jul;119(548):1–8. doi: 10.1192/bjp.119.548.1. [DOI] [PubMed] [Google Scholar]
  24. Zec R. F., Weinberger D. R. Relationship between CT scan findings and neuropsychological performance in chronic schizophrenia. Psychiatr Clin North Am. 1986 Mar;9(1):49–61. [PubMed] [Google Scholar]
  25. Zipursky R. B., Lim K. O., Sullivan E. V., Brown B. W., Pfefferbaum A. Widespread cerebral gray matter volume deficits in schizophrenia. Arch Gen Psychiatry. 1992 Mar;49(3):195–205. doi: 10.1001/archpsyc.1992.01820030027004. [DOI] [PubMed] [Google Scholar]

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