Stereological Volumetry of Cerebral Hemispheres and Lateral Ventricles Using MRI in Schizophrenia Subtypes

Background/ The structural changes of brain (cerebral and lateral ventricles volumes) in schizophrenia are controversial. This is partly due to the heterogenicity of the schizophrenia subtypes. In this study we compared the changes in the volumes of cerebral hemispheres and lateral ventricles in 3 subtypes of schizophrenia (paranoid, undifferentiated and residual) with normal controls. 29 schizophrenia patients (21 men, 8 women) of 3 subtypes of paranoid, undifferentiated, and residual (according to DMS-IV criteria) were compared with 29 age- and gender-matched normal controls. All cases and controls underwent 3-D brain MRI of full coronal series, 1.5 mm slices without interslice gaps. The hemispheres and lateral ventricles were outlined and their volumes were calculated using Cavalieri’s Principle. The results were statistically analyzed. The brain was slightly but insignificantly smaller in the schizophrenia patients. Only the residual subtype showed a significant reduction in cerebral and hemispheric volumes than controls (p<0.05). The volumes of right and left ventricle, separately and together were larger than controls (p<0.03). The ventricle-to-brain ratios (VBRs) were greater in the cases (p<0.05). The paranoid subtype patients had larger ventricles and VBRs than controls (p<0.05). The lateral ventricle volumes and VBRs in the undifferentiated subtype were similar to the controls. In the residual subtypes, the ventricular volumes were similar to and the VBRs were larger than controls (p<0.05). Schizophrenia is a heterogeneous disorder regarding its symptoms and neuropathological changes. The patterns of change in the cerebral and ventricular volumes differed in the studied 3 subtypes.