MRI study of cavum septi pellucidi in schizophrenia, affective disorder, and schizotypal personality disorder

Abstract

Objective: A cavum between the septi pellucidi may reflect neurodevelopmental anomalies in midline structures of the brain. The authors examined cavum septi pellucidi in subjects with schizophrenia, affective disorder, and schizotypal personality disorder and in normal subjects.

Method: Thirty schizophrenic patients (15 chronic, 15 first-episode), 16 patients with affective disorder (first-episode), 21 patients with schizotypal personality disorder, and 46 normal subjects were evaluated with magnetic resonance imaging. Cavum septi pellucidi was assessed by counting the number of 1.5-mm slices containing cavum septi pellucidi.

Results: The presence or absence of cavum septi pellucidi did not differentiate among groups. However, the prevalence of abnormal cavum septi pellucidi (i.e., cavum septi pellucidi contained on four or more slices) was 30.4% for schizophrenic patients (36.4% for chronic, 25.0% for first-episode), 20.0% for patients with affective disorder, 18.8% for patients with schizotypal personality disorder, and 10.3% for normal subjects. When the authors used the Nopoulos et al. criteria for rating cavum septi pellucidi, which omitted borderline cases with cavum septi pellucidi on three slices, the prevalence of abnormal cavum septi pellucidi increased to 35.0% for schizophrenia (40.0% for chronic, 30.0% for first-episode), 25.0% for affective disorder, 27.3% for schizotypal personality disorder, and 13.0% for normal subjects. There was a statistically significant difference in ratings between schizophrenic and normal subjects.

Conclusions: The results suggest that alterations in midline structures during the course of neurodevelopment may play a role in the pathogenesis of schizophrenia.

FIGURE 1

MR Images of Large Cavum Septi Pellucidi in Schizophrenic Patients (left panel) and No Cavum Septi Pellucidi in Normal Subjects (right panel) ^aSame slice number on lower part of pictures. Lower parts of pictures show changes in cavum septi pellucidi in 1.5-mm serial slices containing cavum septi pellucidi.

FIGURE 2

Correlations Between Number of Slices With Cavum Septi Pellucidi and Relative Volumes of Left^a and Right^b Hippocampus in Chronic Schizophrenic Patients ^ar=−0.61, N=15, p=0.02. ^br=−0.60, N=15, p=0.02.