Volume 1 Issue 4 October, 2011
Consultation Liaison Psychiatry Focus: NEUROANATOMY
Schizophrenia is a fascinating disorder for clinicians & researchers in various field of medicine as it is a complex
psychiatric disorder characterized by delusions, hallucinations and or negative symptoms, with high personal and
societal costs. Even the patients and their relatives are curious to know the reason behind altered behavior, they may
insist upon clinician to investigate the Brain!
The illness has prevalence rate of less than 1% in the general population. Efforts to understand its etiology is not new.
Over hundred years ago, Emil Kraeplin & Bleuler described schizophrenia. They were convinced that it was an organic
brain disease, and Alzheimer who worked with Kraeplin, began the neuropathological investigation, before moving to a
more fruitful research area. Subsequently the subject has continued to exasperate researchers in equal measure,
generating more heat than light and being notable for memorable quotes rather than durable data. Of all the methods
used to investigate biologic abnormalities in psychiatric illnesses, neuroanatomical studies have provided some of the
most consistent evidence for brain abnormalities in schizophrenia.
Lateral ventricular & sulcal enlargement particularly in the anterior and temporal horns is the best replicated anatomic
abnormality detected in the brains of patients with schizophrenia, both in earlier CT studies and in many MRI
investigations. With volumetric analysis, reductions found more often for the hippocampus than for any other brain
region. Grey matter appears to be reduced more than white matter. Volumes in specific frontal, temporal, & parietal
cortical sub regions appear to be disproportionately smaller. However, like widespread abnormalities, the significance
of focal cortical volume deficits in schizophrenia remains unknown. There are some gender differences among patients
with Schizophrenia, ventricular size larger in men; however brain volume reduction more marked in women. Planum
temporal volume & other asymmetry reversals marked in men but corpus callosum thickness is in women.
Heteromodal association cortex (HASC) is a highly organized and interconnected neocortical system comprised of the
planum temporale (PT), the dorsolateral prefrontal cortex (DLPFC), Broca’s area, and the inferior parietal lobule
(IPL). Several neurodevelopmental features of HASC may be especially vulnerable to disruptions in neuronal function
or connectivity during brain development, which are also implicated in schizophrenia.
Heteromodal association cortex (HASC) is a highly organized and interconnected neocortical system comprised of the
planum temporale (PT), the dorsolateral prefrontal cortex (DLPFC), Broca’s area, and the inferior parietal lobule
(IPL). Several neurodevelopmental features of HASC may be especially vulnerable to disruptions in neuronal function
or connectivity during brain development, which are also implicated in schizophrenia.
All the data available currently kindles our interest to understand this illness with more sophisticated
investigations like fMRI, SPECT & PET scans. Hope we will know more about, “Brain of Schizophrenia!
What’s inside?”
