Ventricle-brain Ratio Research Articles

Lateral ventricular enlargement and clinical response in schizophrenia

The relationship between enlargement of the lateral ventricles in the brains of schizophrenic patients and clinical response to neuroleptic treatment, as assessed by the ventricle-brain ratio (VBR) and psychopathology scores, was studied in a sample of 39 patients with schizophrenia or schizoaffective psychosis during a drug-free washout and after 3 1/2 weeks of treatment with either haloperidol or thioridazine. There was a weak, but statistically significant positive relationship between VBR and improvement on BPRS Psychosis factor scores after 3 1/2 weeks of treatment, and a negative correlation between VBR and baseline (washout) scores on the BPRS Anergia factor. Patients with enlarged VBRs, as defined by two criteria, also tended to show a better response to neuroleptics than patients below these criterion values.

Early versus late lateral ventricular enlargement following closed head injury.

Serial computed tomographic scans in 39 closed head injury patients were measured by planimetry. The ventricle-brain ratio was computed, and the lateral ventricles were considered to be enlarged or normal based on measurements from a control group. Delayed ventricular enlargement was common after head injury producing low Glasgow Coma Scale scores and prolonged coma, whereas subarachnoid/intraventricular haemorrhage was more common with early enlargement. The degree of ventriculomegaly was related to neuropsychological test performance only when enlargement was delayed. It is postulated that diffuse axonal injury and hypoxic-ischaemic insult contributed to late ventricular enlargement, whereas a compensated obstruction of cerebrospinal fluid may be the predominant cause in the early group.

HYDROCEPHALIC INFANTS

29 hydrocephalic infants (less than 30 months) who had shunts were studied with the 'Bayley Mental Scale' and with computed tomography. It was found that patients with a medical history indicating brain injury in addition to hydrocephalus had lower scores on the 'Bayley Mental Scale' than a comparable group whose hydrocephalus had been uncomplicated. Dilatation of the lateral ventricles was assessed by computing the ventricle-brain ratio (VBR) from the CT scan. The VBR was inversely correlated with the 'Bayley Mental Scale' score. Two thirds of the sample were reevaluated after 1 year; there was a significant decrease in VBR, but mental quotient was unchanged. These findings are in agreement with studies on older children in that the prognosis for cognitive functioning in hydrocephalic children is affected by brain injury. A correlation between brain mass and intelligence has been reported in older children with uncomplicated hydrocephalus, but not in groups with mixed etiology.

Dopamine-beta-hydroxylase activity and homovanillic acid in spinal fluid of schizophrenics with brain atrophy.

Schizophrenic patients with high ventricle brain ratios and cortical brain atrophy, as shown by computerized tomography, had decreased spinal fluid concentrations of homovanillic acid and dopamine-beta-hydroxylase activity. These decreased cerebral spinal fluid concentrations in patients with brain atrophy support the proposal of disturbed noradrenaline and dopamine neurotransmission in a subgroup of schizophrenic patients.

CT scanning in senile dementia. A follow-up of survivors.

Survivors from a group of 40 carefully evaluated subjects with senile dementia who had been scanned over two years previously were followed-up, re-scanned and given simple cognitive tests. Of the 12 survivors, 10 agreed to participate. These fell into two sub-groups: one who showed further deterioration in cognitive function and one who did not. The first sub-group showed an increase in ventricle-brain ratio while the second did not. Although the numbers were too small for clear statistical differences to emerge, there was a tendency for affective admixture to be a favourable prognostic indicator and low radiological attenuation density particularly in the right parietal region to be an unfavourable one.

Computed Tomography in Schizophrenics and Normal Volunteers

Recent findings of enlarged ventricles and sulcal widening in the computed tomographic (CT) scans of schizophrenic subjects have raised questions about the etiology and treatment of this disorder. Measures obtained from computerized analyses of CT scans of 30 schizophrenic and 33 normal subjects showed no significant difference between the groups in ventricular or sulcal fluid volumes. The discrepancy between our findings and those of other investigators may have been due to different measurement techniques or to differences in the samples. A second study was undertaken to examine the first possibility. Its results suggest that our findings and those based on measurements of planimetric ventricle-brain ratios (VBRs) are highly correlated, but that VBRs from one study may not be compared with those in another to establish population differences. Differences in patient samples appear to constitute an important source of discrepancy in CT findings.

Cerebral ventricular enlargement in subtypes of chronic schizophrenia.

A computed tomographic study of the brain in 55 young men with chronic schizophrenia and 27 age- and sex-matched control subjects showed a significantly higher ventricle-brain ratio (VBR) in the patients with chronic schizophrenia. Using the Tsuang-Winokur criteria, the sample was classified into paranoid and nonparanoid-hebephrenic subtypes. Nonparanoid patients who did not fulfill the criteria for hebephrenia were grouped as a nonparanoid-undifferentiated subtype. All three groups of subtypes had a significantly higher mean VBR than control subjects. Among the schizophrenia subtypes, the paranoid and nonparanoid-hebephrenic groups were not different, and both had a significantly larger mean VBR than the nonparanoid-undifferentiated group. The results suggest that although the extent of ventricular enlargement varies among schizophrenia subtypes, they all show a significant enlargement compared with the control group. Also, in contrast with previous reports linking a high VBR with negative symptoms, poor prognosis, and impaired cognition, the data in this study show the largest mean VBR in the paranoid patients who generally have a good premorbid history, positive symptoms, less impaired cognition, and relatively better prognosis.

Hydrocephalic Infants: Developmental Assessment and Computed Tomography

29 hydrocephalic infants (less than 30 months) who had shunts were studied with the 'Bayley Mental Scale' and with computed tomography. It was found that patients with a medical history indicating brain injury in addition to hydrocephalus had lower scores on the 'Bayley Mental Scale' than a comparable group whose hydrocephalus had been uncomplicated. Dilatation of the lateral ventricles was assessed by computing the ventricle-brain ratio (VBR) from the CT scan. The VBR was inversely correlated with the 'Bayley Mental Scale' score. Two thirds of the sample were reevaluated after 1 year; there was a significant decrease in VBR, but mental quotient was unchanged. These findings are in agreement with studies on older children in that the prognosis for cognitive functioning in hydrocephalic children is affected by brain injury. A correlation between brain mass and intelligence has been reported in older children with uncomplicated hydrocephalus, but not in groups with mixed etiology.

Quantitative indexes of computed tomography in dementia and normal aging.

Quantitative indexes of compute tomography were compared in 28 patients with Alzheimer dementia and in 30 elderly persons with no history of neurologic disease. Age-corrected ventricle-brain ratios were abnormal for half of the dementia patients, whereas only a single subject in the control group had ventricles outside the limits of normal variation. Measurement of the distance between the third ventricle and Sylvian fissure indicated that the dementia patients had significantly more atrophy in this area. Employment of quantitative indexes standardized for age may aid in differentiating cerebral atrophy associated with dementia from that associated with normal aging.