Combination of volume and perfusion parameters reveals different types of grey matter changes in schizophrenia

Lixue Xu,Wen Qin,Chuanjun Zhuo,Jiajia Zhu,Huaigui Liu,Chunshui Yu

doi:10.1038/s41598-017-00352-z

Abstract

Diverse brain structural and functional changes have been reported in schizophrenia. Identifying different types of brain changes may help to understand the neural mechanisms and to develop reliable biomarkers in schizophrenia. We aimed to categorize different grey matter changes in schizophrenia based on grey matter volume (GMV) and cerebral blood flow (CBF). Structural and perfusion magnetic resonance imaging data were acquired in 100 schizophrenia patients and 95 healthy comparison subjects. Voxel-based GMV comparison was used to show structural changes, CBF analysis was used to demonstrate functional changes. We identified three types of grey matter changes in schizophrenia: structural and functional impairments in the anterior cingulate cortex and insular cortex, displaying reduction in both GMV and CBF; structural impairment with preserved function in the frontal and temporal cortices, demonstrating decreased GMV with normal CBF; pure functional abnormality in the anterior cingulate cortex and lateral prefrontal cortex and putamen, showing altered CBF with normal GMV. By combination of GMV and CBF, we identified three types of grey matter changes in schizophrenia. These findings may help to understand the complex manifestations and to develop reliable biomarkers in schizophrenia.

Highlights

Schizophrenia is a neuropsychiatric disorder with complicated structural and functional changes, resulting in diverse clinical manifestations
Based on grey matter volume (GMV) and cerebral blood flow (CBF) changes, we identified three types of grey matter changes in schizophrenia: (1) both GMV and CBF reduction in the anterior cingulate cortex (ACC) and anterior insular cortex; (2) GMV reduction with normal CBF in the insular cortex, MPFC, posterior MCC (pMCC), superior temporal gyrus (STG), middle temporal gyrus (MTG), thalamus and amygdala; and (3) CBF reduction with normal GMV in the ACC and lateral prefrontal cortex (LPFC) as well as CBF increase with normal GMV in the putamen
Both GMV and CBF reduction were found in the anterior insular cortex and ACC in schizophrenia patients, indicating both structural and functional impairments in these regions

Summary

Introduction

Schizophrenia is a neuropsychiatric disorder with complicated structural and functional changes, resulting in diverse clinical manifestations. The cerebral blood flow (CBF) is a reliable imaging index to characterize brain functional changes. The CBF is closely coupled with glucose utilization and oxygen consumption, reflects the local neuronal activity[8] Both increased and decreased regional CBF have been observed in schizophrenia[9, 10]. The combination of brain structural and functional changes may help to identify several types of meaningful regional brain alterations in schizophrenia. The voxel-based GMV comparisons between patients and controls were used to identify structurally impaired brain regions in schizophrenia. In brain regions with GMV reduction, the voxel-based CBF comparisons were performed to further identify regions with and without CBF reduction. The similar CBF analysis was performed in brain regions without GMV reduction to detect pure functional abnormality in schizophrenia

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