Several, although not all, of the previous small diffusion-weighted imaging (DWI) studies have shown cortical white-matter disruption in schizophrenia.
To investigate cortical white-matter ...microstructure with DWI in a large community-based sample of people with schizophrenia.
Sixty-eight people with schizophrenia and 64 healthy controls underwent a session of DWI to obtain the apparent diffusion coefficient (ADC) of white-matter water molecules. Regions of interest were placed in cortical lobes.
Compared with controls, the schizophrenia group had significantly greater ADCs in frontal, temporal and occipital white matter (analysis of covariance, P < 0.05).
Our findings confirm the presence of cortical white-matter microstructure disruption in frontal and temporo-occipital lobes in the largest sample of people with schizophrenia thus for studied with this technique. Future brain imaging studies, together with genetic investigations, should further explore white-matter integrity and genes encoding myelin-related protein expression in people with first-episode schizophrenia and those at high risk of developing the disorder.
Corpus callosum (CC) is the main white matter commissure between the two cerebral hemispheres. Abnormalities of CC have been shown in schizophrenia patients by magnetic resonance imaging (MRI) ...studies. We here further investigated CC organization with diffusion imaging (DWI) in a sample of schizophrenia patients recruited from the epidemiologically defined catchment area of South Verona, Italy.
Sixty-seven patients with schizophrenia and 70 normal controls were studied. Regions of interests (ROIs), standardized at 5 pixels, were placed in CC on the non-diffusion weighted echoplanar images (
b
=
0) and were then automatically transferred to the corresponding maps to obtain the apparent diffusion coefficient (ADC) of water molecules.
ADC measures for all callosal subregions in schizophrenia patients were significantly greater compared to normal controls (ANCOVA,
p
<
0.05). Positive symptoms significantly correlated with anterior callosal ADC measures (partial correlation analyses,
p
<
0.05).
These findings support the existence of widespread microstructure disruption of CC in schizophrenia, which may ultimately lead to inter-hemispheric misconnection, and also suggest a specific role of anterior transcallosal disconnectivity in underlying positive symptoms. Future longitudinal MRI studies in high risk and first-episode patients together with neurophysiological tests are indicated to further examine CC anatomical abnormalities and inter-hemispheric transmission in schizophrenia.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Community-based psychiatric services and programs developed in accordance with the 1978 Italian psychiatric reform have now been in operation for a quarter of a century. The paper presents the ...results of a study in which three treatment environments of South-Verona, i.e. a general hospital psychiatric ward, a community mental health center (CMHC) and two residential facilities have been investigated using the Ward Atmosphere Scale (WAS) and the Community Oriented Programs Environment Scale (COPES). Staff and patient ratings have been collected in the three environments thus allowing comparisons between respondents and settings. For the ward and the CMHC, whose staff had already been interviewed almost twenty years before, a comparison between studies was also possible. Results seem to show that original policies, attitudes and staff commitment have successfully survived the passage of time with only minor adjustments and that the single-staff module of South-Verona may have effectively contributed in this respect.
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