Structural brain abnormalities in patients with schizophrenia and 22q11 deletion syndrome

BACKGROUND 22q11 Deletion Syndrome is a genetic syndrome associated with an increased risk for developing schizophrenia. Brain abnormalities have been reported in 22q11 Deletion Syndrome, but little is known about whether differences in brain structure underlie the psychotic disorders associated with this syndrome. In the current study, we used magnetic resonance imaging to characterize the structural brain abnormalities found in adults who have both 22q11 Deletion Syndrome and schizophrenia. METHODS Magnetic resonance imaging brain scans of 14 adults (7 male, 7 female) with 22q11 Deletion Syndrome and schizophrenia and 14 age- and gender-matched healthy volunteers were analyzed to derive measures of gray matter, white matter, and cerebrospinal fluid. Differences between the two groups were tested using student t tests. RESULTS 22q11 Deletion Syndrome and schizophrenia subjects had significantly smaller total gray matter volume (t = 2.88, p <.01) and larger lateral ventricles (t = 4.08, p <.001) than healthy controls. Gray matter deficits were most prominent in the frontal and temporal lobes. Total white matter volumes did not differ between the two groups. CONCLUSIONS Findings from this 22q11 Deletion Syndrome and schizophrenia study are similar to those reported in other patients with schizophrenia, but only partially consistent with those reported in nonpsychotic children with 22q11 Deletion Syndrome. 22q11 Deletion Syndrome may provide a valuable genetic neurodevelopmental model for investigating the relationship between abnormalities in brain development and the expression of schizophrenia.

[1]  D. Mathalon,et al.  A quantitative magnetic resonance imaging study of changes in brain morphology from infancy to late adulthood. , 1994, Archives of neurology.

[2]  R. Weksberg,et al.  Chromosomal abnormalities and schizophrenia. , 2000, American journal of medical genetics.

[3]  R. Murray,et al.  Reduction of cortical volume in schizophrenia on magnetic resonance imaging , 1993, Psychological Medicine.

[4]  K. Lim,et al.  Differing effects of duration of illness on CT findings in alcoholism and schizophrenia. , 1988, Psychopharmacology bulletin.

[5]  R. Langevin,et al.  Deficits in gray matter volume are present in schizophrenia but not bipolar disorder 1 This work was presented at the Meeting of the Society of Biological Psychiatry, Philadelphia, PA, USA, May 1994. 1 , 1997, Schizophrenia Research.

[6]  J G Hennessey,et al.  Reliability and validity of an algorithm for fuzzy tissue segmentation of MRI. , 1998, Journal of computer assisted tomography.

[7]  J. M. Cattell,et al.  The Psychological Corporation , 1923, Science.

[8]  E. Zackai,et al.  Cerebellar atrophy in a patient with velocardiofacial syndrome. , 1995, Journal of medical genetics.

[9]  R. Shprintzen,et al.  Further delineation of brain anomalies in velo-cardio-facial syndrome. , 1995, American journal of medical genetics.

[10]  David N. Kennedy,et al.  A Twin MRI Study of Size Variations in the Human Brain , 2000, Journal of Cognitive Neuroscience.

[11]  R. Shprintzen,et al.  Additional eye findings in a girl with the velo-cardio-facial syndrome. , 1986, American journal of medical genetics.

[12]  R. Kikinis,et al.  Quantitative volumetric MRI study of the cerebellum and vermis in schizophrenia: clinical and cognitive correlates. , 1999, The American journal of psychiatry.

[13]  D. Wechsler WAIS-R manual : Wechsler adult intelligence scale-revised , 1981 .

[14]  J. Rapoport,et al.  Velocardiofacial syndrome in childhood-onset schizophrenia. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[15]  M. Haapanen,et al.  Velocardiofacial syndrome: analysis of phoniatric and other clinical findings. , 1993, Folia phoniatrica.

[16]  J. Graham,et al.  Chromosome 22q1l Deletion Syndrome: An Update and Review for the Primary Pediatrician , 1997, Clinical pediatrics.

[17]  Daniel R. Weinberger,et al.  Medial temporal lobe structures in schizophrenia: relationship of size to duration of illness , 1994, Schizophrenia Research.

[18]  R. Kikinis,et al.  MRI study of cavum septi pellucidi in schizophrenia, affective disorder, and schizotypal personality disorder. , 1998, The American journal of psychiatry.

[19]  J. Rapoport,et al.  Frequency and severity of enlarged cavum septi pellucidi in childhood-onset schizophrenia. , 1998, The American journal of psychiatry.

[20]  S Eliez,et al.  Children and adolescents with velocardiofacial syndrome: a volumetric MRI study. , 2000, The American journal of psychiatry.

[21]  M. Torrens Co-Planar Stereotaxic Atlas of the Human Brain—3-Dimensional Proportional System: An Approach to Cerebral Imaging, J. Talairach, P. Tournoux. Georg Thieme Verlag, New York (1988), 122 pp., 130 figs. DM 268 , 1990 .

[22]  J. Ehrhardt,et al.  Regional brain abnormalities in schizophrenia measured with magnetic resonance imaging. , 1994, JAMA.

[23]  K O Lim,et al.  A profile of cortical gray matter volume deficits characteristic of schizophrenia. , 1998, Cerebral cortex.

[24]  K O Lim,et al.  Widespread cerebral gray matter volume deficits in schizophrenia. , 1992, Archives of general psychiatry.

[25]  B. Turetsky,et al.  Temporolimbic volume reductions in schizophrenia. , 2000, Archives of general psychiatry.

[26]  A. Aurias,et al.  DiGeorge syndrome and related syndromes associated with 22q11.2 deletions. A review. , 1995, Annales de genetique.

[27]  E. Zackai,et al.  Autosomal dominant "Opitz" GBBB syndrome due to a 22q11.2 deletion. , 1995, American journal of medical genetics.

[28]  S. Charles Schulz,et al.  Meta-analysis of brain and cranial size in schizophrenia , 1996, Schizophrenia Research.

[29]  T. Jernigan,et al.  LATE CHILDHOOD CHANGES IN BRAIN MORPHOLOGY OBSERVABLE WITH MRI , 1990, Developmental medicine and child neurology.

[30]  R. Weksberg,et al.  22q11 deletion syndrome in adults with schizophrenia. , 1998, American journal of medical genetics.

[31]  Allan L. Reiss,et al.  Automated Talairach atlas-based parcellation and measurement of cerebral lobes in children , 1999, Psychiatry Research: Neuroimaging.

[32]  Godfrey D Pearlson,et al.  Regional cortical white matter reductions in velocardiofacial syndrome: a volumetric MRI analysis , 2001, Biological Psychiatry.

[33]  Edith V. Sullivan,et al.  Cortical gray matter volume deficits in schizophrenia: a replication , 1996, Schizophrenia Research.

[34]  David J Mikulis,et al.  Qualitative MRI findings in adults with 22q11 deletion syndrome and schizophrenia , 1999, Biological Psychiatry.

[35]  A. Bassett,et al.  22q11 deletion syndrome: a genetic subtype of schizophrenia , 1999, Biological Psychiatry.

[36]  G D Pearlson,et al.  MRI brain changes in subjects with Down syndrome with and without dementia , 1998, Developmental medicine and child neurology.

[37]  D J Mikulis,et al.  Cerebral gray matter volume deficits in first episode psychosis. , 1998, Archives of general psychiatry.

[38]  A. Toga,et al.  Localizing Age-Related Changes in Brain Structure between Childhood and Adolescence Using Statistical Parametric Mapping , 1999, NeuroImage.

[39]  R. Shprintzen,et al.  Velo-cardio-facial syndrome: language and psychological profiles. , 1985, Journal of craniofacial genetics and developmental biology.

[40]  K. Devriendt,et al.  Intelligence and psychosocial adjustment in velocardiofacial syndrome: a study of 37 children and adolescents with VCFS. , 1997, Journal of medical genetics.

[41]  S Eliez,et al.  Velocardiofacial syndrome: are structural changes in the temporal and mesial temporal regions related to schizophrenia? , 2001, The American journal of psychiatry.

[42]  R. Shprintzen,et al.  Brain anomalies in velo-cardio-facial syndrome. , 1994, American journal of medical genetics.

[43]  L. Shaffer,et al.  Submicroscopic deletions at 22q11.2: variability of the clinical picture and delineation of a commonly deleted region. , 1993, American journal of medical genetics.

[44]  High Rates of Schizophrenia in Adults With Velo-Cardio-Facial Syndrome , 1999 .

[45]  A. Silverstein Two- and Four-Subtest Short Forms of the Wechsler Adult Intelligence Scale-Revised. , 1982 .

[46]  R. Weksberg,et al.  Phenotype of adults with the 22q11 deletion syndrome: A review. , 1999, American journal of medical genetics.

[47]  O. Spreen,et al.  Predicting premorbid IQ: A revision of the national adult reading test , 1989 .

[48]  R. Shprintzen,et al.  Schizophrenia susceptibility associated with interstitial deletions of chromosome 22q11. , 1995, Proceedings of the National Academy of Sciences of the United States of America.

[49]  B. Turetsky,et al.  Reduced dorsal and orbital prefrontal gray matter volumes in schizophrenia. , 2000, Archives of general psychiatry.

[50]  E. Kandel,et al.  Prospects for neurology and psychiatry. , 2001, JAMA.

[51]  J. Rapoport,et al.  Progressive cortical change during adolescence in childhood-onset schizophrenia. A longitudinal magnetic resonance imaging study. , 1999, Archives of general psychiatry.

[52]  R A Zimmerman,et al.  Enlarged Sylvian fissures in infants with interstitial deletion of chromosome 22q11. , 1997, American journal of medical genetics.