Progressive lateral ventricular enlargement in schizophrenia: A meta-analysis of longitudinal MRI studies
Received 22 March 2010; accepted 26 March 2010. published online 31 May 2010.
Abstract
Background
Lateral ventricular enlargement is one of the most consistent findings in patients with schizophrenia; however whether progressive ventricular dilation occurs during the course of the illness has been controversial. To clarify this we conducted a meta-analysis of longitudinal studies measuring the lateral ventricles in patients with schizophrenia and a control group.
Methods
The MEDLINE database was searched from 1980 to 2009 for longitudinal MRI studies of patients with schizophrenia. We identified 13 studies that measured the lateral ventricles in both patients and controls and these were included in a random effects meta-analysis. The effect of various clinical variables was investigated in a meta-regression analysis.
Results
Patients showed evidence of progressive ventricular enlargement after illness onset greater than that seen in controls (effect size=0.45, 95%CI 0.19–0.71, p=0.0006). A sub-analysis of chronic patients with schizophrenia with a mean duration of illness of 7.6years at baseline scan also showed progressive ventricular enlargement (p=0.002). The results were robust to inclusion criteria, and no significant effect of age of onset, duration of illness, or age at baseline scan, was found in the meta-regression analysis.
Conclusions
The meta-analysis shows progressive changes in ventricular volume a number of years after illness onset and challenges an exclusively neurodevelopmental model of schizophrenia.
aCentre for Neuroimaging Sciences, Institute of Psychiatry, King's College London, UK
bBiostatistics, Institute of Psychiatry, King's College London, UK
cVA Boston Healthcare System, and Harvard Medical School, Brockton, Massachusetts, USA
Corresponding author. Box PO89, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. Tel.: +44 20 3228 3057; fax: +44 20 3228 2116.
ABSTRACT