Voxel-Based Morphometric Analysis of Gray Matter in First Episode Schizophrenia

By Marek Kubicki, Martha Elizabeth Shenton, D. Salisbury, Y. Hirayasu, K. Kasai, Ron Kikinis, Ferenc A. Jolesz, Robert W. McCarley. NeuroImage, 2002

363 citations recorded by the source corpus.

Voxel-based morphometry (VBM) may afford a more rapid and extensive survey of gray matter abnormalities in schizophrenia than manually drawn region of interest (ROI) analysis, the current gold standard in structural MRI. Unfortunately, VBM has not been validated by comparison with ROI analyses, nor used in first-episode patients with schizophrenia or affective psychosis, who lack structural changes associated with chronicity. An SPM99-based implementation of VBM was used to compare a group of 16 patients with first-episode schizophrenia and a group of 18 normal controls and, as a further comparison, 16 first-episode patients with affective psychosis. All groups were matched for age and handedness. High spatial resolution structural images were normalized to the SPM99 template and then segmented, smoothed, and subjected to an ANCOVA. Schizophrenia vs control group comparisons: Voxel-by-voxel comparison of gray matter densities showed that only the left STG region was significantly different when corrected for multiple comparisons (P <.05), consistent with our previously reported manual ROI results. Analysis of the extent of voxel clusters, replicated with permutation analyses, revealed group differences in bilateral anterior cingulate gyri and insula (not previously examined by us with manually drawn ROI) and unilateral parietal lobe, but not in medial temporal lobe (where our ROI analysis had shown differences). However, use of a smaller smoothing kernel and a small volume correction revealed left-sided hippocampal group differences. Affective psychosis comparisons: When the same statistical thresholding criteria were used, no significant differences between affective psychosis patients and controls were noted. Since a major interest was whether patients with affective psychosis shared some anatomical abnormalities with schizophrenia, we applied a small volume correction and searched within the regions that were significantly less dense in schizophrenia compared to control subjects. With this statistical correction, the insula showed, bilaterally, the same pattern of differences in affective disorder subjects as that in schizophrenic subjects, whereas both left STG and left hippocampus showed statistical differences between affectives and schizophrenics, indicating the abnormalities specific to first-episode schizophrenia. These findings suggest both the promise and utility of VBM in evaluating gray matter abnormalities. They further suggest the importance of comparing VBM findings with more traditional ROI analyses until the reasons for the differences between methods are determined.

Subfields: Cognitive Neuroscience, Psychiatry and Mental health, Radiology, Nuclear Medicine and Imaging

View Paper: https://www.semanticscholar.org/paper/8e228b7af6d571bf273dd1280b208bc72ffd8609

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Citations in the corpus

Diffusion tensor imaging with tract-based spatial statistics reveals local white matter abnormalities in preterm infants (2007, background): “In addition, ROI studies are time consuming and often have significant inter-subject variability which does not easily allow for comparison of many brain regions or large subject groups (Giuliani et al., 2005; Kubicki et al., 2002).”
Why voxel-based morphometric analysis should be used with great caution when characterizing group differences (2004, background): “…2001; Thompson et al., 1997) has gained attention in the neuroimaging literature (Good et al., 2002; Hulshoff Pol et al., 2001; Job et al., 2002; Kubicki et al., 2002; Mehta et al., 2003), mostly because it does not require an a priori knowledge of how brain structure is affected by disease or…”
Whole-brain voxel-based statistical analysis of gray matter and white matter in temporal lobe epilepsy (2004, methodology): “This technique has been used to reveal pathological changes in GM and WM in various neurological conditions, including Alzheimer’s disease and schizophrenia (Karas et al., 2003; Kubicki et al., 2002).”
The anatomy of first-episode and chronic schizophrenia: an anatomical likelihood estimation meta-analysis. (2008, neutral): “(29) First-episode Both 16 18 Treatment: 1.”
Regional deficits in brain volume in schizophrenia: a meta-analysis of voxel-based morphometry studies. (2005, methodology): “In the right hemisphere, the coordinates are located in the right arcuate fasciculus (24), primary auditory cortex ( 18 ), Brodmann’s area 38 (35, 37), Brodmann’s area 22 (36, 37), and Brodmann’s area 41 (31).”
Voxel-based morphometry of the human brain: Methods and applications (2005, background): “In recent years, VBM studies have been successful in characterizing structural brain differences in a variety of diseases including schizophrenia [10], developmental and congenital disorders [11], autism [12], Kallman’s syndrome [13], Klinefelter’s syndrome [14], bipolar disorders [15], cluster head”
Decreased volume of left and total anterior insular lobule in schizophrenia. (2006, background): “Furthermore, the volume of the insula has been shown, by our group and others, to be smaller in volume in schizophrenia than in controls (Crespo-Facorro et al., 2000; Goldstein et al., 1999; Kasai et al., 2003; Kim et al., 2003; Kubicki et al., 2002; Paillere-Martinot et al., 2001; Sigmundsson et al”
Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: the orbitofronto-striatal model revisited. (2008, background): “…is demonstrated by schizophrenia research, where this has consistently revealed decreased grey matter concentrations in the insula, an unpredicted area not previously examined in earlier ROI studies (Wright et al., 1999; Sigmundsson et al., 2001; Hulshoff Pol et al., 2002; Kubicki et al., 2002).”