Abstract
Schizophrenia is a common, severe, and chronically disabling mental illness of unknown cause. Recent MRI studies have focused attention on white matter abnormalities in schizophrenia using diffusion tensor imaging (DTI). Indices commonly derived from DTI include (1) mean diffusivity, independent of direction, (2) fractional anisotropy (FA) or relative anisotropy (RA), (3) axial diffusivity, and (4) radial diffusivity. In cerebral white matter, contributions to these indices come from fiber arrangements, degree of myelination, and axonal integrity. Relatively pure deficits in myelin result in a modest increase in radial diffusivity, without affecting axial diffusivity and with preservation of anisotropy. Although schizophrenia is not characterized by gross abnormalities of white matter, it does involve a profound dysregulation of myelin-associated gene expression, reductions in oligodendrocyte numbers, and marked abnormalities in the ultrastructure of myelin sheaths. Since each oligodendrocyte myelinates as many as 40 axon segments, changes in the number of oligodendrocytes (OLG), and/or in the integrity of myelin sheaths, and/or axoglial contacts can have a profound impact on signal propagation and the integrity of neuronal circuits. Whereas a number of studies have revealed inconsistent decreases in anisotropy in schizophrenia, we and others have found increased FA in key subcortical tracts associated with the circuits underlying symptom generation in schizophrenia. We review data revealing increased anisotropy in dopaminergic tracts in the mesencephalon of schizophrenics and their unaffected relatives, and discuss the possible biological underpinnings and physiological significance of this finding.
Highlights
WHAT DOES diffusion tensor imaging (DTI) MEASURE? Diffusion MRI allows to estimates brain fiber structures using water diffusion properties as a probe (Mori, 2007)
Increased fractional anisotropy (FA) in the arcuate fasciculus bilaterally is likely to contribute to the pathophysiology underlying hallucinations in schizophrenia (Alba-Ferrara et al, 2012); it combines with reduced functional connectivity between the posterior superior temporal gyrus and the anterior cingulate cortex resulting in difficulties to judge whether verbal stimuli are originated in the brain or come from an external source (Alba-Ferrara et al, 2012)
We found that FA was increased in dopaminergic tracts of both schizophrenia patients and their unaffected first degree relatives, when compared to healthy controls (Toranzo et al, 2011)
Summary
WHAT DOES DTI MEASURE? Diffusion MRI allows to estimates brain fiber structures using water diffusion properties as a probe (Mori, 2007). In spite of the uneven contributions of axon and myelin to anisotropy, changes to each of these structures cannot be distinguished on the basis of diffusion tensor imaging (DTI) results.
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