Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-24T04:32:18.741Z Has data issue: false hasContentIssue false

Ventricular Enlargement in Schizophrenia

The Validity of Computerised Tomographic Findings

Published online by Cambridge University Press:  29 January 2018

Michael A. Reveley*
Affiliation:
Institute of Psychiatry and Maudsley Hospital, De Crespigny Park, Denmark Hill, London SE5 8AF

Summary

There has been a considerable range in both the prevalence of ventricular enlargement and values for ventricular size of both schizophrenics and controls, in studies using computerised tomography (CT). The CT scans of 19 unrelated chronic schizophrenics, all of monozygotic (MZ) twin birth, and 36 age-and-sex-matched normal twins from 18 MZ pairs were examined by linear, planimetric, and semi-automated computerised methods. All methods distinguished schizophrenics from controls at approximately the same level of significance, but partial volume artefact led to a greater than two-fold variation in apparent ventricular size, and significantly reduced the validity and reliability of mechanical planimetric and linear measures. Measurement error may be an important source of artefact in uncontrolled studies using those techniques, and when comparing absolute values across studies, but the use of computerised methods should significantly reduce this source of artefact and allow more meaningful comparison.

Type
Papers
Copyright
Copyright © 1985 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, N. C., Olsen, S. A., Dennert, J. W. & Smith, M. R. (1982a) Ventricular enlargement in schizophrenia: relationship to positive and negative symptoms. American Journal of Psychiatry, 139, 297302.Google ScholarPubMed
Andreasen, N. Smith, M. R., Jacoby, C. G., Dennert, J. W. & Olsen, S. A. (1982b) Ventricular enlargement in schizophrenia: definition and prevalence. American Journal of Psychiatry, 139, 292296.Google ScholarPubMed
Benes, F., Sunderland, P., Jones, B. D., Le May, M., Cohen, B. M. & Lipinski, J. F. (1982) Normal ventricles in young schizophrenics. British Journal of Psychiatry, 141, 9093.CrossRefGoogle ScholarPubMed
Campbell, R., Hays, P., Russell, D. B. & Zacks, D. J. (1979) CT scan variants and genetic heterogeneity in schizophrenia. American Journal of Psychiatry, 139, 722723.Google Scholar
Evans, W. A. (1942) An encephalographic ratio for estimating ventricular enlargement and cerebral atrophy. Archives of Neurology and Psychiatry, 47, 931937.CrossRefGoogle Scholar
Francos, E. & Athanassenas, G. (1982) Differences in lateral brain ventricular size among various types of chronic schizophrenics: Evidence based on a CT study. Acta Psychiatrica Scandinavica, 66, 459463.CrossRefGoogle Scholar
Gluck, E., Radu, E. W., Mundt, C. & Gerhardt, P. (1980) A computed tomographic prolective trohoc study of chronic schizophrenics Neuroradiology, 20, 167171.CrossRefGoogle ScholarPubMed
Golden, C. J., Moses, J. A. Jr., Zelazowski, R., Graber, B. Zatz, L. M., Horvath, T. B. & Berger, P. A. (1980) Cerebral ventricular size and neuropsychological impairment in young chronic schizophrenics. Archives of General Psychiatry, 37, 619623.CrossRefGoogle ScholarPubMed
Jacobi, W. & Winkler, H. (1927) Encephalographische studien en chronich schizophrenen. Archiv fur Psychiatrie und Nervenkrankheiten, 81, 299332.CrossRefGoogle Scholar
Jernigan, T. L., Zatz, L. N., Moses, J. A. & Berger, P. A. (1982) Computed tomography in schizophrenics and normal volunteers: I. Fluid volume. Archives of General Psychiatry, 39, 765770.CrossRefGoogle ScholarPubMed
Johnstone, E. C., Crow, T. J., Frith, C. D., Husband, J. & Kreel, L. (1976) Cerebral ventricular size and cognitive impairment in chronic schizophrenia. Lancet, ii, 924926.CrossRefGoogle Scholar
Johnstone, E. C., Crow, T. J., Frith, C. D., Stevens, M., Kreel, L. & Husband, J. (1978) The dementia of dementia praecox. Acta Psychiatrica Scandinavica, 57, 305324.CrossRefGoogle ScholarPubMed
Van Kammen, D. P., Mann, L. S., Sternberg, D. E., Scheinin, M., Ninan, P. T., Marder, S. R., van Kammen, W. B., Rieder, R. O. & Linnoila, M. (1983) Dopamine-B-hydroxylase activity and homovanillic acid in spinal fluid of schizophrenics with brain atrophy. Science, 220, 974977.CrossRefGoogle Scholar
Luchins, D. J. (1982) Computed tomography in schizophrenia: Disparities in the prevalence of abnormalities. Archives of General Psychiatry, 39, 859860.CrossRefGoogle ScholarPubMed
Moriguchi, I. (1981) A study of schizophrenic brains by computerised tomography scans. Folia Psychiatrica Neurological Japonica, 35, 5572.Google Scholar
Nasrallah, H. A., Jacoby, C. G., McCalley-Whitters, M. & Kuperman, S. (1982) Cerebral ventricular enlargement in subtypes of chronic schizophrenia. Archives of General Psychiatry, 39, 774777.CrossRefGoogle ScholarPubMed
Nyback, H., Berggren, B-M., Hindmarsh, T., Sedvall, G. & Wiesel, F-A. (1983) Cerebroventricular size and cerebrospinal fluid monoamine metabolites in schizophrenic patients and healthy volunteers. Psychiatry Research, 9, 301308.CrossRefGoogle ScholarPubMed
Nyback, H., Wiesel, F-A., Berggren, B-M. & Hindmarsh, T. (1982) Computed tomography of the brain in patients with acute psychosis and in healthy volunteers. Acta Psychiatrica Scandinavica, 65, 403414.CrossRefGoogle ScholarPubMed
Okasha, A. & Madkour, O. (1982) Cortical and central atrophy in chronic schizophrenia: A controlled study. Acta Psychiatrica Scandinavica, 65, 2934.CrossRefGoogle ScholarPubMed
Pearlson, G. D. & Veroff, A. E. (1981) Computerised tomography scan changes in manic depressive illness. Lancet, ii, 470.CrossRefGoogle Scholar
Penn, R. D., Belanger, M. G. & Yasnoff, W. A. (1978) Ventricular volume in man computed from CAT scans. Annals of Neurology, 3, 216223.CrossRefGoogle ScholarPubMed
Potkin, S. G., Weinberger, D. R., Linnoila, M. & Wyatt, R. J. (1983) Low CSF 5-hydroxyindoleacetic acid in schizophrenic patients with enlarged cerebral ventricles. American Journal of Psychiatry, 140, 2125.Google ScholarPubMed
Reveley, A. M. & Reveley, M. A. (1983) Aqueduct stenosis and schizophrenia. Journal of Neurology, Neurosurgery and Psychiatry, 46, 1822.CrossRefGoogle ScholarPubMed
Reveley, A. M., Reveley, M. A., Clifford, C. & Murray, R. M. (1982) Cerebral ventricular size in twins discordant for schizophrenia. Lancet, i, 540541.CrossRefGoogle Scholar
Reveley, A. M., Reveley, M. A., & Murray, R. M. (1984) Cerebral ventricular enlargement in non-genetic schizophrenia: A controlled twin study. British Journal of Psychiatry, 144, 8993.CrossRefGoogle ScholarPubMed
Reveley, M. A., de Belleroche, J., Recordati, A. & Hirsch, S. (1983) Increased CSF amino acids and ventricular enlargement in schizophrenia. Abstracts of the Seventh World Congress of Psychiatry, Vienna, p. 493.Google Scholar
Rieder, R. O., Mann, L. S., Weinberger, D. R., van Kammen, D. P. & Post, R. M. (1983) Computed tomographic scans in patients with schizophrenia, schizoaffective and bipolar affective disorder. Archives of General Psychiatry, 40, 735739.CrossRefGoogle ScholarPubMed
Schulz, S. C., Koller, M. M., Kishore, P. R., Hamer, R. M., Gehl, J. J. & Friedel, R. O. (1983) Ventricular enlargement in teenage patients with schizophrenia spectrum disorder. American Journal of Psychiatry, 140, 15921595.Google ScholarPubMed
Spitzer, R. L. & Endicott, J. (1979) The Schedule for Affective Disorders and Schizophrenia (SADS) (3rd Edition). New York: New York State Psychiatric Institute.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1975) Research Diagnostic Criteria. Instrument No. 58. New York: New York State Psychiatric Institute.Google ScholarPubMed
Synek, V., Reuben, J. R. & Du Boulay, G. H. (1976) Comparing Evans' Index and computerised axial tomography in assessing relationship of ventricular size to brain size. Neurology, 26, 231233.CrossRefGoogle Scholar
Tanaka, Y., Hazama, H., Kawahara, R. & Kobayashi, K. (1981) Computerised tomography of the brain in schizophrenic patients: A controlled study. Acta Psychiatrica Scandinavica, 63, 191197.CrossRefGoogle ScholarPubMed
Trimble, M. & Kingsley, D. (1978) Cerebral ventricular size in chronic schizophrenia. Lancet, i, 278279.CrossRefGoogle Scholar
Weinberger, D. R., Bigelow, L. B., Kleinman, J. E., Klein, S. T., Rosenblatt, J. E. & Wyatt, R. J. (1980b) Cerebral ventricular enlargement in chronic schizophrenia. Archives of General Psychiatry, 37, 1113.CrossRefGoogle ScholarPubMed
Weinberger, D. R., Cannon-Spoor, E., Potkin, S. G. & Wyatt, R. J. (1980a) Poor pre-morbid adjustment and CT scan abnormalities in chronic schizophrenia. American Journal of Psychiatry, 137, 14101413.Google Scholar
Weinberger, D. R., DeLisi, L. E., Perman, G. P., Targum, S. & Wyatt, R. J. (1982) Computed tomography in schizophreniform disorder and other acute psychiatric disorders. Archives of General Psychiatry, 39, 778783.CrossRefGoogle ScholarPubMed
Weinberger, D. R., Torrey, E. F., Neophytides, A. N. & Wyatt, R. J. (1979) Lateral cerebral ventricular enlargement in chronic schizophrenia. Archives of General Psychiatry, 36, 735739.CrossRefGoogle ScholarPubMed
Williams, A. O., Reveley, M. A., Kolakowaka, T., Arden, M. & Mandelbrote, B. M. Schizophrenia with good and poor outcome. II. Cerebral ventricular size and its clinical significance. British Journal of Psychiatry, 146, 239246.CrossRefGoogle Scholar
Zatz, L. M. & Jernigan, T. L. (1983) The ventricular-brain ratio on computed tomography scans: Validity and proper use. Psychiatry Research, 8, 207214.CrossRefGoogle ScholarPubMed
Zatz, L. M. & Ahumada, A. J. Jr. (1982) Changes on computed cranial tomography with aging: Intracranial fluid volume. American Journal of Neuroradiology, 3, 111.Google ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.