Progressive brain changes in schizophrenia: a 1-year follow-up study of diffusion tensor imaging

Objective: Recent cross-sectional studies suggest that brain changes in schizophrenia are progressive during the course of the disorder. However, it remains unknown whether this is a global process or whether some brain areas are affected to a greater degree. The aim of this study was to examine the longitudinal brain changes in patients with chronic older schizophrenia by magnetic resonance imaging (MRI). Methods: Three-dimensional (3D) T1-weighted and diffusion tensor (DT) MRI were performed twice on each of 16 chronic older schizophrenia patients (mean age = 58.1 +/- 6.7 years ) with an interval of 1 year between imaging sessions. To clarify the longitudinal morphological and white matter changes, volume data and normalised diffusion tensor imaging (DTI) metrics were compared between the first and follow-up studies using a paired t-test. Results: Focal cortical volume loss was observed in the left prefrontal lobe and anterior cingulate on volumetric study. In addition, DTI metrics changed significantly at the bilateral posterior superior temporal lobes, left insula, genu of the corpus callosum and anterior cingulate. Conclusion: There are ongoing changes in the brains of schizophrenic patients during the course of the illness. Discrepancies between volume data and DTI metrics may indicate that the pattern of progressive brain changes varies according to brain region.