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The British Journal of Psychiatry (2005) 186: 369-377
© 2005 The Royal College of Psychiatrists

Regional volume deviations of brain structure in schizophrenia and psychotic bipolar disorder

Computational morphometry study

Colm McDonald, MRCPsych

Division of Psychological Medicine, Institute of Psychiatry, London

Ed Bullmore, MRCPsych, PhD

Brain Mapping Unit, University of Cambridge, Department of Psychiatry, Addenbrooke’s Hospital, Cambridge

Pak Sham, MRCPsych, PhD and Xavier Chitnis, MSc

Division of Psychological Medicine, Institute of Psychiatry, London

John Suckling, PhD

Brain Mapping Unit, University of Cambridge, Department of Psychiatry, Addenbrooke’s Hospital, Cambridge

James MacCabe, MRCPsych, Muriel Walshe, BA and Robin M. Murray, FRCPsych, DSc

Division of Psychological Medicine, Institute of Psychiatry, London.

Correspondence: Dr Colm McDonald, Division of Psychological Medicine, Box 63, Institute of Psychiatry, de Crespigny Park, London SE5 8AF, UK.Tel: +44 (0)20 7848 0057; fax: ++444 (0)2 (0)20 7701 9044; e-mail: c.mcdonald{at}iop.kcl.ac.uk

Declaration of interest None.

Funding detailed in Acknowledgement.

Background It is unclear whether schizophrenia and psychotic bipolar disorder are associated with similar deviations of brain morphometry.

Aims To assess volumetric abnormalities of grey and white matter throughoutthe entire brain in individuals with schizophrenia or with bipolar disorder compared with the same control group.

Method Brain scans were obtained by magnetic resonance imaging from 25 people with schizophrenia, 37 with bipolar disorder who had experienced psychotic symptoms and 52 healthy volunteers. Regional deviation in grey and white matter volume was assessed using computational morphometry.

Results Individuals with schizophrenia had distributed grey matter deficit predominantly involving the fronto-temporal neocortex, medial temporal lobe, insula, thalamus and cerebellum, whereas those with bipolar disorder had no significant regions of grey matter abnormality. Both groups had anatomically overlapping white matter deficits in regions normally occupied by major longitudinal and interhemispheric tracts.

Conclusions Schizophrenia and psychotic bipolar disorder are associated with distinct grey matter deficits but anatomically coincident white matter abnormalities.




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