Subcortical brain volume abnormalities in 2028 individuals with schizophrenia and 2540 healthy controls via the ENIGMA consortium

The profile of brain structural abnormalities in schizophrenia is still not fully understood, despite decades of research using brain scans. To validate a prospective meta-analysis approach to analyzing multicenter neuroimaging data, we analyzed brain MRI scans from 2028 schizophrenia patients and 2540 healthy controls, assessed with standardized methods at 15 centers worldwide. We identified subcortical brain volumes that differentiated patients from controls, and ranked them according to their effect sizes. Compared with healthy controls, patients with schizophrenia had smaller hippocampus (Cohen’s d=−0.46), amygdala (d=−0.31), thalamus (d=−0.31), accumbens (d=−0.25) and intracranial volumes (d=−0.12), as well as larger pallidum (d=0.21) and lateral ventricle volumes (d=0.37). Putamen and pallidum volume augmentations were positively associated with duration of illness and hippocampal deficits scaled with the proportion of unmedicated patients. Worldwide cooperative analyses of brain imaging data support a profile of subcortical abnormalities in schizophrenia, which is consistent with that based on traditional meta-analytic approaches. This first ENIGMA Schizophrenia Working Group study validates that collaborative data analyses can readily be used across brain phenotypes and disorders and encourages analysis and data sharing efforts to further our understanding of severe mental illness.

[1]  Godfrey D. Pearlson,et al.  Lateral ventricular enlargement associated with persistent unemployment and negative symptoms in both schizophrenia and bipolar disorder , 1984, Psychiatry Research.

[2]  Edgar Erdfelder,et al.  GPOWER: A general power analysis program , 1996 .

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

[4]  R. Gur,et al.  Subcortical MRI volumes in neuroleptic-naive and treated patients with schizophrenia. , 1998, The American journal of psychiatry.

[5]  Michael D. Nelson,et al.  Hippocampal volume reduction in schizophrenia as assessed by magnetic resonance imaging : A meta-analytic study , 1998 .

[6]  Kevin T. Hansen,et al.  Searching the schizophrenic brain for temporal lobe deficits: a systematic review and meta-analysis , 2000, Psychological Medicine.

[7]  R. Murray,et al.  Meta-analysis of regional brain volumes in schizophrenia. , 2000, The American journal of psychiatry.

[8]  A. Dale,et al.  Whole Brain Segmentation Automated Labeling of Neuroanatomical Structures in the Human Brain , 2002, Neuron.

[9]  R. Kahn,et al.  Volume changes in gray matter in patients with schizophrenia. , 2002, The American journal of psychiatry.

[10]  Oili Salonen,et al.  Contributions of genetic risk and fetal hypoxia to hippocampal volume in patients with schizophrenia or schizoaffective disorder, their unaffected siblings, and healthy unrelated volunteers. , 2002, The American journal of psychiatry.

[11]  D. Altman,et al.  Measuring inconsistency in meta-analyses , 2003, BMJ : British Medical Journal.

[12]  Eve C. Johnstone,et al.  Voxel-based morphometry of patients with schizophrenia or bipolar disorder and their unaffected relatives , 2004, Biological Psychiatry.

[13]  W. Heindel,et al.  Dehydration confounds the assessment of brain atrophy , 2005, Neurology.

[14]  A. Vita,et al.  Brain morphology in first-episode schizophrenia: A meta-analysis of quantitative magnetic resonance imaging studies , 2006, Schizophrenia Research.

[15]  R. Duman,et al.  Neurogenic Actions of Atypical Antipsychotic Drugs and Therapeutic Implications , 2007, CNS drugs.

[16]  Terry L. Jernigan,et al.  Basal ganglia volumes in drug-naive first-episode schizophrenia patients before and after short-term treatment with either a typical or an atypical antipsychotic drug , 2007, Psychiatry Research: Neuroimaging.

[17]  I. Cuthill,et al.  Effect size, confidence interval and statistical significance: a practical guide for biologists , 2007, Biological reviews of the Cambridge Philosophical Society.

[18]  R. Kahn,et al.  What happens after the first episode? A review of progressive brain changes in chronically ill patients with schizophrenia. , 2007, Schizophrenia bulletin.

[19]  J. Vázquez-Barquero,et al.  Epidemiological factors associated with treated incidence of first‐episode non‐affective psychosis in Cantabria: insights from the Clinical Programme on Early Phases of Psychosis , 2008, Early intervention in psychiatry.

[20]  R. Passingham,et al.  Is Gray Matter Volume an Intermediate Phenotype for Schizophrenia? A Voxel-Based Morphometry Study of Patients with Schizophrenia and Their Healthy Siblings , 2008, Biological Psychiatry.

[21]  J. Vázquez-Barquero,et al.  Specific brain structural abnormalities in first-episode schizophrenia. A comparative study with patients with schizophreniform disorder, non-schizophrenic non-affective psychoses and healthy volunteers. , 2009, Schizophrenia Research.

[22]  Anders M. Dale,et al.  MRI-derived measurements of human subcortical, ventricular and intracranial brain volumes: Reliability effects of scan sessions, acquisition sequences, data analyses, scanner upgrade, scanner vendors and field strengths , 2009, NeuroImage.

[23]  Robin M. Murray,et al.  Higher cortisol levels are associated with smaller left hippocampal volume in first-episode psychosis , 2010, Schizophrenia Research.

[24]  Joost Janssen,et al.  Hippocampal volume change in schizophrenia. , 2010, The Journal of clinical psychiatry.

[25]  Peter Falkai,et al.  Hippocampal plasticity in response to exercise in schizophrenia. , 2010, Archives of general psychiatry.

[26]  Carlo Caltagirone,et al.  Updated meta-analyses reveal thalamus volume reduction in patients with first-episode and chronic schizophrenia , 2010, Schizophrenia Research.

[27]  B. Pakkenberg,et al.  Stereological brain volume changes in post-weaned socially isolated rats , 2010, Brain Research.

[28]  Peter B. Jones,et al.  Association between duration of untreated psychosis and brain morphology in schizophrenia within the Northern Finland 1966 Birth Cohort , 2010, Schizophrenia Research.

[29]  Rachel M. Brouwer,et al.  Segmentation of MRI brain scans using non-uniform partial volume densities , 2010, NeuroImage.

[30]  Matthew Lee Smith,et al.  Yule-Simpson's Paradox in Research. , 2010 .

[31]  O. Gruber [Neuroimaging markers: their role for differential diagnosis and therapeutic decisions in personalized psychiatry]. , 2011, Der Nervenarzt.

[32]  Ronald Pierson,et al.  Long-term antipsychotic treatment and brain volumes: a longitudinal study of first-episode schizophrenia. , 2011, Archives of general psychiatry.

[33]  D. Collier,et al.  Volume increases in putamen associated with positive symptom reduction in previously drug-naive schizophrenia after 6 weeks antipsychotic treatment , 2011, Psychological Medicine.

[34]  R. Murray,et al.  Structural Magnetic Resonance Imaging in Bipolar Disorder: An International Collaborative Mega-Analysis of Individual Adult Patient Data , 2011, Biological Psychiatry.

[35]  Anders D. Børglum,et al.  Genome-wide association study identifies five new schizophrenia loci , 2011, Nature Genetics.

[36]  Guido Gerig,et al.  Differences in subcortical structures in young adolescents at familial risk for schizophrenia: A preliminary study , 2012, Psychiatry Research: Neuroimaging.

[37]  Vaughan J. Carr,et al.  Systematic meta-review and quality assessment of the structural brain alterations in schizophrenia , 2012, Neuroscience & Biobehavioral Reviews.

[38]  A. Toga,et al.  Disease and genetic contributions toward local tissue volume disturbances in schizophrenia: A tensor‐based morphometry study , 2012, Human brain mapping.

[39]  Ron Mengelers,et al.  The Effects of FreeSurfer Version, Workstation Type, and Macintosh Operating System Version on Anatomical Volume and Cortical Thickness Measurements , 2012, PloS one.

[40]  D. Prvulovic,et al.  Cortical–basal ganglia imbalance in schizophrenia patients and unaffected first-degree relatives , 2012, Schizophrenia Research.

[41]  Eske M Derks,et al.  Focal and global brain measurements in siblings of patients with schizophrenia. , 2012, Schizophrenia bulletin.

[42]  J. Ballenger Brain Volume Changes After Withdrawal of Atypical Antipsychotics in Patients With First-Episode Schizophrenia , 2012 .

[43]  P. Falkai,et al.  DISC1 (disrupted-in-schizophrenia 1) is associated with cortical grey matter volumes in the human brain: a voxel-based morphometry (VBM) study. , 2013, Journal of psychiatric research.

[44]  R. Kahn,et al.  Brain volumes in schizophrenia: a meta-analysis in over 18 000 subjects. , 2013, Schizophrenia bulletin.

[45]  N. Andreasen,et al.  Progressive brain changes in schizophrenia related to antipsychotic treatment? A meta-analysis of longitudinal MRI studies , 2013, Neuroscience & Biobehavioral Reviews.

[46]  R. S. Kahn,et al.  Confounders of excessive brain volume loss in schizophrenia , 2013, Neuroscience & Biobehavioral Reviews.

[47]  Alexander Kogan,et al.  Northwestern University Schizophrenia Data and Software Tool (NUSDAST) , 2013, Front. Neuroinform..

[48]  M. Daly,et al.  Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis , 2013, The Lancet.

[49]  N. Wray,et al.  A mega-analysis of genome-wide association studies for major depressive disorder , 2013, Molecular Psychiatry.

[50]  Randy L. Gollub,et al.  The MCIC Collection: A Shared Repository of Multi-Modal, Multi-Site Brain Image Data from a Clinical Investigation of Schizophrenia , 2013, Neuroinformatics.

[51]  Boxpress,et al.  Schizophrenia and comorbid cannabis use disorders : Brain structure , function and the effect of antipsychotic medications ' s-Hertogenbosch : Boxpress , 2014 .

[52]  D. Arnold,et al.  Correlation between brain volume change and T2 relaxation time induced by dehydration and rehydration: Implications for monitoring atrophy in clinical studies , 2014, NeuroImage: Clinical.

[53]  D. G. Clark,et al.  Basal ganglia volume in unmedicated patients with schizophrenia is associated with treatment response to antipsychotic medication , 2014, Psychiatry Research: Neuroimaging.

[54]  V. Calhoun,et al.  Smoking status as a potential confounder in the study of brain structure in schizophrenia. , 2014, Journal of psychiatric research.

[55]  Joseph A. King,et al.  Global Cortical Thinning in Acute Anorexia Nervosa Normalizes Following Long-Term Weight Restoration , 2015, Biological Psychiatry.