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Current Psychiatry Reports
Published in: Current Psychiatry Reports 1/2012

Open Access 01-02-2012 | PERSONALITY DISORDERS (H KOENIGSBERG, SECTION EDITOR)

A Review of Structural MRI and Diffusion Tensor Imaging in Schizotypal Personality Disorder

Authors: Erin A. Hazlett, Kim E. Goldstein, Jeanine C. Kolaitis

Published in: Current Psychiatry Reports | Issue 1/2012

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Abstract

Individuals with schizotypal personality disorder (SPD) share genetic, phenomenologic, and cognitive abnormalities with people diagnosed with schizophrenia. To date, 15 structural MRI studies of the brain have examined size, and 3 diffusion tensor imaging studies have examined white matter connectivity in SPD. Overall, both types of structural neuroimaging modalities have shown temporal lobe abnormalities similar to those observed in schizophrenia, while frontal lobe regions appear to show more sparing. This intriguing pattern suggests that frontal lobe sparing may suppress psychosis, which is consistent with the idea of a possible neuroprotective factor. In this paper, we review these 18 studies and discuss whether individuals with SPD who both resemble and differ from schizophrenia patients in their phenomenology, share some or all of the structural brain imaging characteristics of schizophrenia. We attempt to group the MRI abnormalities in SPD into three patterns: 1) a spectrum of severity—abnormalities are similar to those observed in schizophrenia but not so severe; 2) a spectrum of region—abnormalities affecting some, but not all, brain regions affected in schizophrenia; and 3) a spectrum of compensation—abnormalities reflecting greater-than-normal white matter volume, possibly serving as a buffer or compensatory mechanism protecting the individual with SPD from the frank psychosis observed in schizophrenia.
Literature
1.
Kraepelin E. Manic-depressive insanity and paranoia. Edinburgh: E. and S. Livingstone; 1919.
2.
Bleuler E. Dementia praecox or the group of schizophrenias. New York: International Universities Press; 1950.
3.
Kety SS, Rosenthal D, Wender PH, et al. Mental illness in the biological and adoptive families of adopted schizophrenics. Am J Psychiatry. 1971;128(3):302–6.PubMed
4.
Rosenthal D, Wender PH, Kety SS, et al. The adopted-away offspring of schizophrenics. Am J Psychiatry. 1971;128(3):307–11.PubMed
5.
Siever LJ, Davis KL. The pathophysiology of schizophrenia disorders: perspectives from the spectrum. Am J Psychiatry. 2004;161(3):398–413.PubMedCrossRef
6.
American-Psychiatric-Association. DSM-IV: diagnostic and statistical manual of mental disorders. 4th ed. Washington, D.C.: APA; 1994.
7.
Bergman AJ, Harvey PD, Mitropoulou V, et al. The factor structure of schizotypal symptoms in a clinical population. Schizophr Bull. 1996;22(3):501–9.PubMed
8.
Raine A, Reynolds C, Lencz T, et al. Cognitive-perceptual, interpersonal, and disorganized features of schizotypal personality. Schizophr Bull. 1994;20(1):191–201.PubMed
9.
Chakos M, Lieberman J, Bilder R. Increase in caudate nuclei volume of first episode schizophrenia patients taking antipsychotic drugs. Am J Psychiatry. 1994;151:1430–6.PubMed
10.
Dickey CC, McCarley RW, Shenton ME. The brain in schizotypal personality disorder: a review of structural MRI and CT findings. Harv Rev Psychiatry. 2002;10(1):1–15.PubMedCrossRef
11.
•• Shenton ME, Whitford TJ, Kubicki M. Structural neuroimaging in schizophrenia: from methods to insights to treatments. Dialogues Clin Neurosci. 2010;12(3):317–32. This paper provides an excellent review and integration of neuroimaging studies in schizophrenia. PubMed
12.
Eisenberg DP, Berman KF. Executive function, neural circuitry, and genetic mechanisms in schizophrenia. Neuropsychopharmacology. 2010;35(1):258–77.PubMedCrossRef
13.
Sanz JH, Karlsgodt KH, Bearden CE, et al. Symptomatic and functional correlates of regional brain physiology during working memory processing in patients with recent onset schizophrenia. Psychiatry Res. 2009;173(3):177–82.PubMedCrossRef
14.
Yoneyama E, Matsui M, Kawasaki Y, et al. Gray matter features of schizotypal disorder patients exhibiting the schizophrenia-related code types of the Minnesota Multiphasic Personality Inventory. Acta Psychiatr Scand. 2003;108(5):333–40.PubMedCrossRef
15.
Kawasaki Y, Suzuki M, Nohara S, et al. Structural brain differences in patients with schizophrenia and schizotypal disorder demonstrated by voxel-based morphometry. Eur Arch Psychiatry Clin Neurosci. 2004;254(6):406–14.PubMedCrossRef
16.
Raine A, Lencz T, Yaralian P, et al. Prefrontal structural and functional deficits in schizotypal personality disorder. Schizophr Bull. 2002;28(3):501–13.PubMed
17.
Suzuki M, Zhou SY, Takahashi T, et al. Differential contributions of prefrontal and temporolimbic pathology to mechanisms of psychosis. Brain. 2005;128(Pt 9):2109–22.PubMedCrossRef
18.
• Hazlett EA, Buchsbaum MS, Haznedar MM, et al. Cortical gray and white matter volume in unmedicated schizotypal and schizophrenia patients. Schizophr Res. 2008;101:111–23. This paper examined volume of frontal and temporal lobe regions across the schizophrenia spectrum in a large sample of healthy controls, individuals with schizotypal personality disorder, and schizophrenia. PubMedCrossRef
19.
Devinsky O, Morrell MJ, Vogt BA. Contributions of anterior cingulate cortex to behaviour. Brain. 1995;118(Pt 1):279–306.PubMedCrossRef
20.
Takahashi T, Suzuki M, Kawasaki Y, et al. Volumetric magnetic resonance imaging study of the anterior cingulate gyrus in schizotypal disorder. Eur Arch Psychiatry Clin Neurosci. 2002;252(6):268–77.PubMedCrossRef
21.
Haznedar MM, Buchsbaum MS, Hazlett EA, et al. Cingulate gyrus volume and metabolism in the schizophrenia spectrum. Schizophr Res. 2004;71(2–3):249–62.PubMedCrossRef
22.
Goldstein KE, Hazlett EA, New AS, et al. Smaller superior temporal gyrus volume specificity in schizotypal personality disorder. Schizophr Res. 2009;112(1–3):14–23.PubMedCrossRef
23.
Byne W, Buchsbaum MS, Kemether E, et al. Magnetic resonance imaging of the thalamic mediodorsal nucleus and pulvinar in schizophrenia and schizotypal personality disorder. Arch Gen Psychiatry. 2001;58(2):133–40.PubMedCrossRef
24.
Suzuki M, Zhou SY, Hagino H, et al. Volume reduction of the right anterior limb of the internal capsule in patients with schizotypal disorder. Psychiatry Res. 2004;130(3):213–25.PubMedCrossRef
25.
Zhou SY, Suzuki M, Hagino H, et al. Decreased volume and increased asymmetry of the anterior limb of the internal capsule in patients with schizophrenia. Biol Psychiatry. 2003;54(4):427–36.PubMedCrossRef
26.
Shenton ME, Dickey CC, Frumin M, et al. A review of MRI findings in schizophrenia. Schizophr Res. 2001;49(1–2):1–52.PubMedCrossRef
27.
Levitt JJ, Bobrow L, Lucia D, et al. A selective review of volumetric and morphometric imaging in schizophrenia. Curr Top Behav Neurosci. 2010;4:243–81.PubMedCrossRef
28.
Dickey CC, McCarley RW, Voglmaier MM, et al. Schizotypal personality disorder and MRI abnormalities of temporal lobe gray matter. Biol Psychiatry. 1999;45(11):1393–402.PubMedCrossRef
29.
Downhill JE, Buchsbaum MS, Hazlett EA, et al. Temporal lobe volume determined by magnetic resonance imaging in schizotypal personality disorder and schizophrenia. Schizophr Res. 2001;48(2–3):187–99.PubMedCrossRef
30.
Takahashi T, Suzuki M, Zhou SY, et al. Morphologic alterations of the parcellated superior temporal gyrus in schizophrenia spectrum. Schizophr Res. 2006;83(2–3):131–43.PubMedCrossRef
31.
Takahashi T, Suzuki M, Zhou SY, et al. A follow-up MRI study of the superior temporal subregions in schizotypal disorder and first-episode schizophrenia. Schizophr Res. 2010;119(1–3):65–74.PubMedCrossRef
32.
Dickey CC, McCarley RW, Voglmaier MM. An MRI study of superior temporal gyrus volume in women with schizotypal personality disorder. Am J Psychiatry. 2003;160:2198–201.PubMedCrossRef
33.
Dickey CC, McCarley RW, Voglmaier MM, et al. Smaller left Heschl’s gyrus volume in patients with schizotypal personality disorder. Am J Psychiatry. 2002;159(9):1521–7.PubMedCrossRef
34.
Dickey CC, McCarley RW, Xu ML, et al. MRI abnormalities of the hippocampus and cavum septi pellucidi in females with schizotypal personality disorder. Schizophr Res. 2007;89(1–3):49–58.PubMedCrossRef
35.
Takahashi T, Suzuki M, Zhou SY, et al. Temporal lobe gray matter in schizophrenia spectrum: a volumetric MRI study of the fusiform gyrus, parahippocampal gyrus, and middle and inferior temporal gyri. Schizophr Res. 2006;87(1–3):116–26.PubMedCrossRef
36.
Basser PJ, Mattiello J, LeBihan D. MR diffusion tensor spectroscopy and imaging. Biophys J. 1994;66(1):259–67.PubMedCrossRef
37.
Moseley ME, Cohen Y, Kucharczyk J, et al. Diffusion-weighted MR imaging of anisotropic water diffusion in cat central nervous system. Radiology. 1990;176(2):439–45.PubMed
38.
Pierpaoli C, Jezzard P, Basser PJ, et al. Diffusion tensor MR imaging of the human brain. Radiology. 1996;201(3):637–48.PubMed
39.
Basser PJ, Mattiello J, LeBihan D. Estimation of the effective self-diffusion tensor from the NMR spin echo. J Magn Reson B. 1994;103(3):247–54.PubMedCrossRef
40.
Thomason ME, Thompson PM. Diffusion imaging, white matter, and psychopathology. Annu Rev Clin Psychol. 2011;7:63–85.PubMedCrossRef
41.
Pajevic S, Pierpaoli C. Color schemes to represent the orientation of anisotropic tissues from diffusion tensor data: application to white matter fiber tract mapping in the human brain. Magn Reson Med. 1999;42(3):526–40.PubMedCrossRef
42.
White T, Nelson M, Lim KO. Diffusion tensor imaging in psychiatric disorders. Top Magn Reson Imaging. 2008;19(2):97–109.PubMedCrossRef
43.
Akbarian S, Kim JJ, Potkin SG, et al. Maldistribution of interstitial neurons in prefrontal white matter of the brains of schizophrenic patients. Arch Gen Psychiatry. 1996;53(5):425–36.PubMedCrossRef
44.
Friston KJ, Frith CD. Schizophrenia: a disconnection syndrome? Clin Neurosci. 1995;3(2):89–97.PubMed
45.
Meyer-Lindenberg A, Poline JB, Kohn PD, et al. Evidence for abnormal cortical functional connectivity during working memory in schizophrenia. Am J Psychiatry. 2001;158(11):1809–17.PubMedCrossRef
46.
Weinberger DR, Berman KF, Suddath R, et al. Evidence of dysfunction of a prefrontal-limbic network in schizophrenia: a magnetic resonance imaging and regional cerebral blood flow study of discordant monozygotic twins. Am J Psychiatry. 1992;149(7):890–7.PubMed
47.
• Ellison-Wright I, Bullmore E. Meta-analysis of diffusion tensor imaging studies in schizophrenia. Schizophr Res. 2009;108(1–3):3–10. This paper was the first to conduct a comprehensive review of DTI studies in schizophrenia. It provides a good review and integration of the literature. PubMedCrossRef
48.
Kubicki M, Westin CF, Nestor PG, et al. Cingulate fasciculus integrity disruption in schizophrenia: a magnetic resonance diffusion tensor imaging study. Biol Psychiatry. 2003;54(11):1171–80.PubMedCrossRef
49.
Kumra S, Ashtari M, McMeniman M, et al. Reduced frontal white matter integrity in early-onset schizophrenia: a preliminary study. Biol Psychiatry. 2004;55(12):1138–45.PubMedCrossRef
50.
Lim KO, Hedehus M, Moseley M, et al. Compromised white matter tract integrity in schizophrenia inferred from diffusion tensor imaging. Arch Gen Psychiatry. 1999;56(4):367–74.PubMedCrossRef
51.
Sun Z, Wang F, Cui L, et al. Abnormal anterior cingulum in patients with schizophrenia: a diffusion tensor imaging study. NeuroReport. 2003;14(14):1833–6.PubMedCrossRef
52.
Szeszko PR, Robinson DG, Ashtari M, et al. Clinical and neuropsychological correlates of white matter abnormalities in recent onset schizophrenia. Neuropsychopharmacology. 2008;33(5):976–84.PubMedCrossRef
53.
Tamminga CA, Vogel M, Gao X, et al. The limbic cortex in schizophrenia: focus on the anterior cingulate. Brain Res. 2000;31(2–3):364–70.
54.
Wang F, Sun Z, Cui L, et al. Anterior cingulum abnormalities in male patients with schizophrenia determined through diffusion tensor imaging. Am J Psychiatry. 2004;161(3):573–5.PubMedCrossRef
55.
Ashtari M, Cottone J, Ardekani BA, et al. Disruption of white matter integrity in the inferior longitudinal fasciculus in adolescents with schizophrenia as revealed by fiber tractography. Arch Gen Psychiatry. 2007;64(11):1270–80.PubMedCrossRef
56.
Konrad A, Winterer G. Disturbed structural connectivity in schizophrenia primary factor in pathology or epiphenomenon? Schizophr Bull. 2008;34(1):72–92.PubMedCrossRef
57.
Kanaan RA, Shergill SS, Barker GJ, et al. Tract-specific anisotropy measurements in diffusion tensor imaging. Psychiatry Res. 2005.
58.
Nakamura M, McCarley RW, Kubicki M, et al. Fronto-temporal disconnectivity in schizotypal personality disorder: a diffusion tensor imaging study. Biol Psychiatry. 2005;58(6):468–78.PubMedCrossRef
59.
Gurrera RJ, Nakamura M, Kubicki M, et al. The uncinate fasciculus and extraversion in schizotypal personality disorder: a diffusion tensor imaging study. Schizophr Res. 2007;90(1–3):360–2.PubMedCrossRef
60.
Hazlett EA, Goldstein KE, Tajima-Pozo K, et al. Cingulate and temporal lobe fractional anisotropy in schizotypal personality disorder. NeuroImage. 2011;55(3):900–8.PubMedCrossRef
61.
Raine A. Schizotypal personality: neurodevelopmental and psychosocial trajectories. Annu Rev Clin Psychol. 2006;2:291–326.PubMedCrossRef
62.
Gottesman I, Shields J, Hanson DR. Schizophrenia, the epigenetic puzzle. New York: Cambridge University Press; 1982.
63.
Fujiwara H, Namiki C, Hirao K, et al. Anterior and posterior cingulum abnormalities and their association with psychopathology in schizophrenia: a diffusion tensor imaging study. Schizophr Res. 2007;95(1–3):215–22.PubMedCrossRef
64.
Fujiwara H, Hirao K, Namiki C, et al. Anterior cingulate pathology and social cognition in schizophrenia: a study of gray matter, white matter and sulcal morphometry. NeuroImage. 2007;36(4):1236–45.PubMedCrossRef
65.
Hubl D, Koenig T, Strik W, et al. Pathways that make voices: white matter changes in auditory hallucinations. Arch Gen Psychiatry. 2004;61(7):658–68.PubMedCrossRef
66.
Minami T, Nobuhara K, Okugawa G, et al. Diffusion tensor magnetic resonance imaging of disruption of regional white matter in schizophrenia. Neuropsychobiology. 2003;47(3):141–5.PubMedCrossRef
67.
Mitelman SA, Torosjan Y, Newmark RE, et al. Internal capsule, corpus callosum and long associative fibers in good and poor outcome schizophrenia: a diffusion tensor imaging survey. Schizophr Res. 2007;92(1–3):211–24.PubMedCrossRef
68.
Kubicki M, Westin CF, Maier SE, et al. Uncinate fasciculus findings in schizophrenia: a magnetic resonance diffusion tensor imaging study. Am J Psychiatry. 2002;159(5):813–20.PubMedCrossRef
69.
Burns J, Job D, Bastin ME, et al. Structural disconnectivity in schizophrenia: a diffusion tensor magnetic resonance imaging study. Br J Psychiatry. 2003;182:439–43.PubMedCrossRef
70.
Schneiderman JS, Buchsbaum MS, Haznedar MM, et al. Age and diffusion tensor anisotropy in adolescent and adult patients with schizophrenia. NeuroImage. 2009;45(3):662–71.PubMedCrossRef
Metadata
Title
A Review of Structural MRI and Diffusion Tensor Imaging in Schizotypal Personality Disorder
Authors
Erin A. Hazlett
Kim E. Goldstein
Jeanine C. Kolaitis
Publication date
01-02-2012
Publisher
Current Science Inc.
Published in
Current Psychiatry Reports / Issue 1/2012
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-011-0241-z

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