Gray matter volume decreases in elderly patients with schizophrenia: a voxel-based morphometry study

Area of Science:

• Neuroscience
• Radiology
• Gerontology

Background:

• Aged patients with schizophrenia (>50 years) have distinct clinical and neurological profiles compared to younger individuals.
• This subpopulation faces a higher risk of dementia and exhibits unfavorable disease progression.
• Existing research on age-related brain changes in schizophrenia underrepresents older patients (<17% >50 years).

Purpose of the Study:

• To investigate the specific anatomical distribution of gray matter (GM) brain deficits in aged patients with ongoing schizophrenia.
• To identify age-related GM changes unique to older individuals with schizophrenia.

Main Methods:

• Utilized voxel-based morphometry (VBM) on 3D-T1 magnetic resonance imaging (MRI) scans.
• Analyzed data from 27 aged patients with schizophrenia (mean age 60 years) and 40 age-matched healthy controls.

Main Results:

• Confirmed bilateral gray matter (GM) volume reduction in the thalamus and prefrontal cortex in aged schizophrenia patients.
• Identified significant GM volume reduction in a large posterior region, including the occipito-temporo-parietal junction.
• Observed accelerated GM volume loss with increasing age specifically in this posterior region, independent of institutionalization, medication, or cognitive scores.

Conclusions:

• Replicated known thalamic and frontal GM deficits in schizophrenia patients.
• Discovered a novel, extensive region of GM atrophy in posterior tertiary cortices of aged patients.
• This posterior atrophy may be a characteristic feature of older, chronically symptomatic schizophrenia patients and shows accelerated progression with age.