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Disruption of White Matter Integrity in the Inferior Longitudinal Fasciculus in Adolescents With Schizophrenia as Revealed by Fiber Tractography
Manzar Ashtari, PhD;
John Cottone, PhD;
Babak A. Ardekani, PhD;
Kelly Cervellione, MA;
Philip R. Szeszko, PhD;
Jinghui Wu, BS;
Steven Chen, BS;
Sanjiv Kumra, MD
Arch Gen Psychiatry. 2007;64(11):1270-1280.
Context There is increasing evidence that schizophrenia is characterized by abnormalities in white matter.
Objective To investigate the integrity of white matter tracts in adolescents with schizophrenia.
Design Cross-sectional, case-control, whole-brain, voxel-based analysis and fiber tractography using diffusion tensor magnetic resonance imaging.
Setting University research institute.
Participants Forty-four individuals (age range, 11-18 years), 23 with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder and 21 demographically similar healthy controls.
Main Outcome Measures Fractional anisotropy, trace, and radial diffusivity of diffusion tensor and quantitative tractography.
Results Voxelwise analysis revealed that adolescents with schizophrenia had reduced fractional anisotropy within the left inferior temporal (P < .001) and occipital (P < .001) regions. Tractography was performed to extract the left and the right inferior longitudinal fasciculi (ILF). Measuring the mean diffusion indices along the left ILF, patients had significantly reduced fractional anisotropy (P < .001) as well as significantly increased radial diffusivity (P < .001) and trace (P = .003) after adjusting for differences in a measure thought to reflect premorbid intelligence, Wide Range Achievement Test 3 reading scores. Exploratory analyses revealed that patients with a history of visual hallucinations had lower fractional anisotropy in the left ILF (P = .02) than patients without visual hallucinations.
Conclusion Our findings, which benefited from greater image resolution and methodological control than previous studies conducted in adolescents with schizophrenia, provide strong evidence for lower white matter integrity in the left ILF, particularly for patients with a history of visual hallucinations.
Author Affiliations: Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York (Drs Ashtari, Cottone, and Szeszko; Ms Wu; and Mr Chen); Nathan Kline Institute for Psychiatric Research, Center for Advanced Brain Imaging, Orangeburg, New York (Dr Ardekani); Department of Clinical Research, Jamaica Hospital Medical Center, Jamaica, New York (Ms Cervellione); and Department of Psychiatry, University of Minnesota, Minneapolis (Dr Kumra).
Dr Ashtari is now with the Radiology Department, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.
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