Magnetic resonance imaging

What is magnetic resonance imaging (MRI)?

MRI is a used to visualise the structure of the brain and other regions of the body. It uses the magnetic properties inside cells (such as protons) to create a 3D image of the target region. Understanding structural brain alterations in people with schizophrenia may help understand changes in brain development associated with the illness onset or progression, and may help to inform future treatment strategies.

What is the evidence for MRI brain structure?

High quality evidence suggests significant medium-sized increases in the basal ganglia and ventricular volume (lateral ventricles, third ventricle) in people with schizophrenia. Lower quality evidence suggests reductions in whole brain volume, including grey and white matter, and grey matter of the frontal lobe, superior temporal gyrus, thalamus, anterior cingulate hippocampus, and parahippocampus. There are also reductions in the insula, cingulate gyrus, amygdala, inferior parietal gyrus, and cerebellum; as well as reduced white matter in the frontal lobe, corpus callosum and internal capsule. There is increased frequency of enlarged cavum septum pellucidum and abnormal structural asymmetry in the frontal, temporal and occipital lobes, including Sylvian fissure and Planum temporale. Reductions in grey matter volume of the insular cortex and superior temporal gyrus are associated with increased severity of auditory hallucinations.

In first-degree relatives of people with schizophrenia, moderate to high quality evidence suggests reduced hippocampal and total grey matter volume, reduced grey matter in the left basal ganglia/clastrum, left thalamus/putamen and left insula, and increased third ventricle volume. There are also abnormalities found in people at clinical risk for psychosis who are showing early, mild symptoms.  People with first-episode psychosis show grey matter reductions in the left anterior cingulate, right precuneus, left cerebellum and right superior temporal gyrus compared to people at high-risk of psychosis.

Changes may occur over time in people with schizophrenia, with longitudinal studies suggesting ventricles increased over time, and whole brain volume, frontal lobe grey and white matter, parietal white matter, temporal white matter, left caudate volume, thalamus volume, and caudate volume reduced over time. Moderate quality evidence suggests the left lateral temporal cortex, left inferior frontal gyrus, superior frontal gyrus extending to the left middle frontal gyrus, and the right rectal gyrus all show volume decreases with antipsychotic use, and the left dorsal anterior cingulate cortex, left ventral anterior cingulate cortex and right putamen show volume increases with antipsychotic use.

March 2019

Last updated at: 2:45 am, 28th March 2019
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