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Progressive Ventricular Expansion in Chronic Poor-outcome Schizophrenia

Mitelman, Serge A. MD*; Canfield, Emily L. MA*; Brickman, Adam M. PhD; Shihabuddin, Lina MD*; Hazlett, Erin A. PhD*; Buchsbaum, Monte S. MD

Cognitive & Behavioral Neurology:
doi: 10.1097/WNN.0b013e3181cfb52a
Original Studies

Objective: To compare progressive changes in lateral ventricular size in chronic schizophrenia patients with good and poor outcomes.

Background: Several longitudinal studies associated excessive ventricular enlargement with poor outcome early in the course of schizophrenia. Changes in its chronic phase have not been as well ascertained.

Methods: We used MRI to evaluate progression of the lateral ventricular size in 49 chronic schizophrenia patients (26 with poor outcome, 23 with good outcome) and 16 healthy comparison participants, scanned twice 4 years apart.

Results: In comparison with healthy participants, schizophrenia patients displayed significantly enlarged body, and anterior and posterior horns of the lateral ventricles at baseline and follow-up, but no between-group differences in their longitudinal expansion were observed. Progressive enlargement of the posterior horn in the poor-outcome (Kraepelinian) group, however, was more pronounced than in schizophrenia patients with good outcome.

Conclusions: Excessive ventricular enlargement in the chronic phase of schizophrenia may be specifically associated with poor functional outcome of the illness.

Author Information

*Department of Psychiatry, Mount Sinai School of Medicine

Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY

Departments of Psychiatry and Radiology, University of California San Diego, CA

Reprints: Serge A. Mitelman, MD, Mount Sinai Medical Center, Department of Psychiatry, Box 1505, Neuroscience Positron Emission Tomography Laboratory, One Gustave L. Levy Place, New York, NY 10029 (e-mail:

Received for publication May 11, 2009; accepted December 13, 2009

Supported by NARSAD Young Investigator Award and NIMH MH 077146 grant to Serge A. Mitelman and by NIMH grants P50 MH 66392-01, MH 60023, and MH 56489 to Monte S. Buchsbaum.

© 2010 Lippincott Williams & Wilkins, Inc.