Brain substance deficit with paralimbic and limbic involvement in computerized tomography studies of schizophrenic patients

: In order to determine whether ventricular enlargement in schizophrenia is due to a general brain atrophy or to a more regionally confined reduction of brain tissue, in CT scans of 54 schizophrenics (ICD 9 295.0-6) and 54 controls matched for age and sex the size of all cortical sulci, the Silvian fissures, lateral, third and fourth ventricles were determined by blind planimetry. The left Silvian fissure was on several levels most enlarged (by 79-233%), followed by the right Silvian fissure (42-96%), the frontal parts of the interhemispheric fissure (84%), the left and right frontal sulci (40%, 46%), the VBR (32%), and the third ventricle (25%), whereas the parietal and occipital sulci and the fourth ventricle were not significantly altered. With the exception of one parameter, there was no correlation between any of the data and the duration of the illness. The data indicate that paralimbic and limbic structures of the anterior temporal lobe and of the parasagittal frontal cortex are most affected in schizophrenia. With respect to recent neuroanatomical and neurophysiological findings, an explanation is offered for the close association of some positive schizophrenic symptoms with limbic and paralimbic brain deficiency.