Unraveling the pathophysiology of schizophrenia: insights from structural magnetic resonance imaging studies

Abstract

Background: Schizophrenia affects about 1% of the global population. In addition to the complex etiology, linking this illness to genetic, environmental, and neurobiological factors, the dynamic experiences associated with this disease, such as experiences of delusions, hallucinations, disorganized thinking, and abnormal behaviors, limit neurological consensuses regarding mechanisms underlying this disease.

Methods: In this study, we recruited 72 patients with schizophrenia and 74 healthy individuals matched by age and sex to investigate the structural brain changes that may serve as prognostic biomarkers, indicating evidence of neural dysfunction underlying schizophrenia and subsequent cognitive and behavioral deficits. We used voxel-based morphometry (VBM) to determine these changes in the three tissue structures: the gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF). For both image processing and statistical analysis, we used statistical parametric mapping (SPM).

Results: Our results show that patients with schizophrenia exhibited a significant volume reduction in both GM and WM. In particular, GM volume reductions were more evident in the frontal, temporal, limbic, and parietal lobe, similarly the WM volume reductions were predominantly in the frontal, temporal, and limbic lobe. In addition, patients with schizophrenia demonstrated a significant increase in the CSF volume in the left third and lateral ventricle regions.

Conclusion: This VBM study supports existing research showing that schizophrenia is associated with alterations in brain structure, including gray and white matter, and cerebrospinal fluid volume. These findings provide insights into the neurobiology of schizophrenia and may inform the development of more effective diagnostic and therapeutic approaches.

Keywords: cerebrospinal fluid; gray matter; schizophrenia; statistical parametric mapping; structural MRI; voxel-based morphometry; white matter.

Figure 1

An overview of voxel-based morphometry analyses (52).

Figure 2

Voxel-based morphometric analyses identified gray matter (GM) alterations in the Right inferior frontal gyrus (A), Right middle frontal gyrus (B), Right superior frontal gyrus (C) and Right subcallosal gyrus (D), with statistical significance at p < 0.05 and an extent threshold of K = 100 when SZ < HC.

Figure 3

Voxel-based morphometric analyses identified gray matter (GM) alterations in the Left middle temporal gyrus (A), Left cingulate gyrus (B), and Left postcentral gyrus (C), with statistical significance at p < 0.05 and an extent threshold of K = 100 when SZ < HC.

Figure 4

Voxel-based morphometric analyses identified white matter (WM) alterations in the Left inferior frontal gyrus (A), Right inferior frontal gyrus (B), Right sub-gyral (C) and Left middle frontal gyrus (D), with statistical significance at p < 0.05 and an extent threshold of K = 100 when SZ < HC.

Figure 5

Voxel-based morphometric analyses identified white matter (WM) alterations in the Left superior temporal gyrus (A), Right fusiform gyrus (B), Left middle temporal gyrus (C) and Left parahippocampal gyrus (D), with statistical significance at p < 0.05 and an extent threshold of K = 100 when SZ < HC.

Figure 6

Voxel-based morphometric analyses identified cerebrospinal fluid (CSF) alterations in the Left third ventricle (A), and Left lateral ventricle (B), with statistical significance at p < 0.05 and an extent threshold of K = 100 when SZ > HC.