Corticolimbic Structural Deficits in Violent Patients with Schizophrenia

Background/Objectives: Violent behaviors are uncommon in patients with schizophrenia (Sch), but when present, exacerbate stigma and challenge treatment. The following study aimed to identify the structural abnormalities associated with violent behaviors in Sch by implementing a validated tool specifically designed to evaluate violent behaviors in psychiatric populations, as well as by performing region-of-interest neuroimaging analyses, focused on areas commonly associated with the neurobiology of violence and aggression. Methods: Eighty-three participants were divided into three groups: Sch with violent behaviors (Sch+V, n = 34), Sch without violent behaviors (Sch-V, n = 28), and healthy controls (HC, n = 21). Structural neuroimaging analyses were performed across groups to assess gray matter volume (GMV) and cortical thickness (CT) differences in regions previously implicated in aggressive behaviors. Results: The data revealed significant reductions in GMV in the right amygdala and diminished cortical thickness (CT) in the bilateral dorsolateral prefrontal cortices (dlPFC) in patients with Sch+V compared to patients with Sch-V and HCs. Right amygdalar volume also demonstrated a negative correlational trend with hostility scores in patients with Sch+V. Conclusions: These findings underscore disruptions in the structural integrity of the dlPFC-responsible for inhibitory control-and the amygdala-central to emotional processing in violent patients with Sch. Future research should aim to investigate potential functional interactions at a network level to gain a deeper understanding of the neurobiological underpinnings of violent behaviors in this population.