CT scans and neuroleptic response in schizophrenia: a multidimensional approach

Structural brain abnormalities in schizophrenia have been reported in a number of studies using computed tomography (CT). However, the prevalence and the localization of the abnormalities vary widely among studies. These discrepancies might stem from clinical and demographic differences among samples, from the choice of the CT parameters, or from the use of different criteria to define abnormalities. In an attempt to overcome these difficulties, we studied 12 CT parameters in 30 schizophrenic patients and 30 sex- and age-matched controls, and evaluated the data simultaneously through multidimensional scaling (MDS). MDS offers a graphic representation in which subtle deviations in the different CT parameters can be detected, independently of predetermined criteria for the definition of abnormalities. MDS distinguished 13 patients from the controls as having deviant values in one or more CT parameters. Five of these patients were first-onset schizophrenics. Patients with deviant CT parameters showed significantly poorer response to haloperidol therapy over 3 weeks than did patients without deviant CT parameters. Our results suggest that the MDS approach might be useful in identifying more precisely patients with and without structural brain abnormalities.