Brain Structural Abnormalities in a Group of Never-Medicated Patients With Long-Term Schizophrenia

This study investigated brain morphometry in chronically ill but never-medicated schizophrenia patients and whether the relation of age to morphometric abnormalities differed from that in healthy subjects.

In a cross-sectional design, high-resolution T1-weighted images were acquired from 25 schizophrenia patients with untreated chronic illness lasting 5 to 47 years and 33 matched healthy comparison subjects. Cortical thickness and gray matter volume were compared in the two groups. In regions with significant group differences, nonlinear modeling of age-related effects was used to test for accelerated decline in the patients.

Schizophrenia patients had less cortical thickness in the bilateral ventromedial prefrontal cortices, left superior temporal gyrus, and right pars triangularis, relative to comparison subjects, and greater cortical thickness in the left superior parietal lobe. The relation of age to cortical thickness indicated faster age-related cortical thinning in the right ventromedial prefrontal cortex, left superior temporal gyrus, and right pars triangularis in patients than in comparison subjects, but slower thinning in the left superior parietal lobe. Gray matter volume was greater in the putamen bilaterally and smaller in the right middle temporal gyrus and right lingual gyrus of the patients, but age-related effects did not differ from those of the comparison subjects.

The accelerated age-related decline in prefrontal and temporal cortical thickness in never-medicated schizophrenia patients suggests a neuroprogressive process in some brain regions. Slower age-related cortical thinning of the superior parietal cortex and striatal volumetric abnormalities unrelated to age suggest different pathological processes over time in these regions.