Neuroimaging in schizophrenia: A review article

Mona Dabiri; Fatemeh Dehghani Firouzabadi; Kun Yang; Peter B Barker; Roland R Lee; David M Yousem

doi:10.3389/fnins.2022.1042814

Neuroimaging in schizophrenia: A review article

Front Neurosci. 2022 Nov 15:16:1042814. doi: 10.3389/fnins.2022.1042814. eCollection 2022.

Authors

Mona Dabiri¹, Fatemeh Dehghani Firouzabadi², Kun Yang³, Peter B Barker⁴, Roland R Lee⁵, David M Yousem⁴

Affiliations

¹ Department of Radiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
² Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA, United States.
³ Department of Psychiatry, Molecular Psychiatry Program, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
⁴ Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, MD, United States.
⁵ Department of Radiology, UCSD/VA Medical Center, San Diego, CA, United States.

Abstract

In this review article we have consolidated the imaging literature of patients with schizophrenia across the full spectrum of modalities in radiology including computed tomography (CT), morphologic magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS), positron emission tomography (PET), and magnetoencephalography (MEG). We look at the impact of various subtypes of schizophrenia on imaging findings and the changes that occur with medical and transcranial magnetic stimulation (TMS) therapy. Our goal was a comprehensive multimodality summary of the findings of state-of-the-art imaging in untreated and treated patients with schizophrenia. Clinical imaging in schizophrenia is used to exclude structural lesions which may produce symptoms that may mimic those of patients with schizophrenia. Nonetheless one finds global volume loss in the brains of patients with schizophrenia with associated increased cerebrospinal fluid (CSF) volume and decreased gray matter volume. These features may be influenced by the duration of disease and or medication use. For functional studies, be they fluorodeoxyglucose positron emission tomography (FDG PET), rs-fMRI, task-based fMRI, diffusion tensor imaging (DTI) or MEG there generally is hypoactivation and disconnection between brain regions. However, these findings may vary depending upon the negative or positive symptomatology manifested in the patients. MR spectroscopy generally shows low N-acetylaspartate from neuronal loss and low glutamine (a neuroexcitatory marker) but glutathione may be elevated, particularly in non-treatment responders. The literature in schizophrenia is difficult to evaluate because age, gender, symptomatology, comorbidities, therapy use, disease duration, substance abuse, and coexisting other psychiatric disorders have not been adequately controlled for, even in large studies and meta-analyses.

Keywords: DTI; MRI; PET; functional imaging; psychiatry; psychosis; schizophrenia.

Publication types

Review