Delusions and dorso-medial frontal cortex volume in first-episode schizophrenia: A voxel-based morphometry study

Whitford, Thomas J.; Farrow, Tom F.D.; Williams, Leanne M.; Gomes, Lavier; Brennan, John; Harris, Anthony W.F.

doi:10.1016/j.pscychresns.2008.07.011

« Previous Next »Psychiatry Research: Neuroimaging
Volume 172, Issue 3 , Pages 175-179, 30 June 2009

Delusions and dorso-medial frontal cortex volume in first-episode schizophrenia: A voxel-based morphometry study

Thomas J. Whitford
- The Brain Dynamics Centre, Westmead Millennium Institute and University of Sydney, Westmead, NSW, 2145, Australia
- Corresponding author. The Brain Dynamics Centre, Acacia House, Westmead Hospital, Westmead, NSW, 2145, Australia. Tel.: +61 2 9845 8179; fax: +61 2 9845 8190.
Tom F.D. Farrow
- The Brain Dynamics Centre, Westmead Millennium Institute and University of Sydney, Westmead, NSW, 2145, Australia
- SCANLab, Department of Academic Clinical Psychiatry, University of Sheffield, The Longley Centre, Northern General Hospital, Norwood Grange Drive, Sheffield, S5 7JT, UK
Leanne M. Williams
- The Brain Dynamics Centre, Westmead Millennium Institute and University of Sydney, Westmead, NSW, 2145, Australia
- Discipline of Psychological Medicine, University of Sydney, Sydney, NSW, 2006, Australia
Lavier Gomes
- Department of Radiology, Westmead Hospital, Westmead, NSW, 2145, Australia
John Brennan
- Department of Child and Adolescent Psychiatry, Redbank House, Westmead Hospital, Westmead, NSW, 2145, Australia
Anthony W.F. Harris
- The Brain Dynamics Centre, Westmead Millennium Institute and University of Sydney, Westmead, NSW, 2145, Australia
- Discipline of Psychological Medicine, University of Sydney, Sydney, NSW, 2006, Australia

Received 12 September 2007; received in revised form 9 June 2008; accepted 4 July 2008.

Abstract

Of the few studies that have directly investigated the neuroanatomical correlates of delusions in patients with recent-onset schizophrenia, a number have paradoxically reported a positive correlation between delusion severity and regional grey matter volume. In order to explore this relationship, 31 patients with first-episode schizophrenia (FES) underwent a clinical interview and a T1-weighted structural MRI scan. Patients' scores on the Delusions subscale of the Positive and Negative Syndrome Scale were correlated with the volume of every voxel in their grey matter images in SPM99. Patients' delusion scores were found to correlate with the volume of a cluster of voxels located in the dorso-medial frontal cortex, centred on the medial frontal gyrus. Post-hoc analysis revealed that this ‘region-of-correlation’ was volumetrically reduced in the FES patients relative to a group of 21 matched healthy controls. The results of this study support the hypothesis that while a certain level of structural brain atrophy is necessary for delusion formation in patients with FES, excessive structural atrophy may in fact preclude the formation of highly systematized delusions.

Keywords: Psychopathology, Magnetic resonance imaging (MRI), Neuroanatomy, SPM, Delusions, PANSS