Frontal leukotomy size and hemispheric asymmetries on computerized tomographic scans of schizophrenics with variable recovery. Northampton Veterans Administration study

Abstract

The computerized tomographic (CT) scans of 17 schizophrenic men who had had bilateral prefrontal leukotomy performed 25 years earlier were examined to determine the relationship among leukotomy site, size, hemispheric asymmetries, and recovery. Six cases of good recovery (GR), five of moderate recovery (MR), and six of no recovery (NR) were studied; 16 of 17 patients were right-handed. Results showed that the GR cases had significantly larger lesions in the low orbitofrontal region (especially on the left) than did the other MR and NR cases. Also, five of six of the GR cases had significantly greater lesion size asymmetry in the low orbitofrontal region and overall than did the other MR and NR cases. There was no consistent asymmetry of lesion size (larger right or left) that was associated with recovery. Significant differences were observed in the hemispheric asymmetries of the right-handed schizophrenics vs normal subjects. Only half the cases had the expected increased left occipital width, and half had unexpected equal or increased right occipital widths. All of the GR cases had either an increased left or right occipital width; none had equal widths. Additional observation of long-standing leukotomy sites on CT scans in schizophrenia cases is recommended.