Increased water diffusivity in the frontal and temporal cortices of schizophrenic patients

Schizophrenia has been suggested to be the result of both macroscopic and microscopic abnormalities in the brain. Although no definitive clinico-pathological correlations have been found to reconcile the many facets inherent in this disorder, the recent development of the magnetic resonance diffusion tensor imaging (DTI) has allowed us to gather useful information regarding the microcircuitry of the brain. Specifically, the apparent diffusion coefficient (ADC) reflects the degree of diffusion barriers and heterosynaptic communication for the brain neurotransmitter. Nineteen patients with DSM-IV schizophrenia and 21 age- and sex-matched control subjects participated in DTI, and the severity of the patients' symptoms was evaluated according to the Positive and Negative Syndrome Scale (PANSS). The ADC values were determined and compared between patients and control subjects via voxel-based morphometry. The results show an increased ADC in the bilateral fronto-temporal regions of the schizophrenic patients, as compared with those of the control subjects. In addition, the ADC values in the area of the right insular were correlated with the negative syndromes from the PANSS. Our findings of increased water diffusivity in the fronto-temporal regions of schizophrenic patients and the correlation between negative symptom scales and the ADC in the right insular region indicate that damaged brain microcircuitry might contribute to the pathophysiology of schizophrenia. These findings contribute towards integrating micro and macrostructural abnormalities and syndromes of schizophrenia.