Schizotypal Personality Disorder: Structural and Functional MR Imaging Studies
Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry,
VA Boston Healthcare System, Brockton Division
Martha E. Shenton, Ph.D., Robert W. McCarley, M.D, Lawrence P. Panych, Ph.D., Seung-Schik Yoo, Ph.D., Ron Kikinis, M.D., Ferenc Jolesz, M.D., Paul Nestor, Ph.D., Dean Salisbury, Ph.D., Kiyoto Kasai, M.D., Toshiaki Onitsukato, M.D.,
Margaret Niznikiewicz, Ph.D.,Cynthia Wible, Ph.D., James Levitt, M.D., Melissa Frumin, M.D., Kevin Spencer, Ph.D.,
Xiangyang Li, M.D., Martina Voglmaier, Ph.D., Lawrence Seidman, Ph.D.
The purpose of this research program is to understand the fundamental anatomical abnormalities in schizophrenia by studying a genetically related disorder, schizotypal personality disorder (SPD). SPD shares with schizophrenia genetic, morphologic, electrophysiologic, neuropsychologic, and behavioral abnormalities, yet SPD subjects are not psychotic so have not received neuroleptic medication nor have they been chronically ill. The cardinal features of SPD are excessive social anxiety with few close friends, odd or paranoid thinking, and odd speech and appearance.
To accomplish our goals we have used the most advanced image processing techniques available, including automated algorithms and a 3D surface rendering of neuroanatomy. To date using structural MRI we have shown a gray matter tissue reduction in the left superior temporal gyrus, particularly Heschl's gyrus, and abnormal parahippocampal asymmetry. We have also demonstrated an increase in CSF volume unrelated to lateral ventricle volume.
Following up on these findings, we are expanding our programs by using functional MRI (fMRI) which allows us to examine the functional capacity of these brain areas in this population.
Key Words. Schizophrenia, Schizotypal Personality Disorder, MRI, fMRI, Temporal Lobe Abnormalities, MR Image Processing.
Grant Support. Support for this work comes from a VA Career Development Award (CCD). Additional support comes from the National Institute of Mental Health, the National Institute of Health, the Veterans Affairs, and private foundations, including: NIMH R01 MH50740 Computerized Image Analyses of MR Scans in Schizophrenia (MES), Senior Mentor for the Stanley Scholars Program (MES), which provides support for students to conduct hands-on research, a Veteran Merit Review Award to use MR Brain Diffusion Tensor Imaging to Study Schizophrenia (MES), and two individual projects (MES) for NIH P41 RR13218 Neuroimaging Analysis Center (FJ). Career Awards: NIMH KO2 MH01110 Research Scientist Development Award (MES). Other support includes: NIMH RO1MH40,700, Neurophysiological Studies of Schizophrenia (RWM); RO1 MH52807, Biological Basis of Schizotypal Personality Disorder (RWM); Veterans Administration Merit Review, MRI Anatomy of Schizophrenia (RWM).
Project Sites. Department of Psychiatry, Brain Imaging Laboratory, VA Boston Healthcare System, Brockton Division; Brain Potential Imaging Laboratory, Massachusetts Mental Health Center, Boston, MA; Surgical Planning Laboratory and Department of Radiology, Brigham and Women's Hospital, Boston, MA; Cognitive Neuroscience Laboratory, McLean Hospital, Belmont, MA.
Project Director. Chandlee C. Dickey, M.D., Instructor, Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Harvard Medical School, Boston VA Healthcare System, Brockton Division. Mail Address: Psychiatry 116A, 940 Belmont Street, Brockton, MA 02301. Email: chandlee_dickey@http://hms.harvard.edu
Contact Person. Marie Fairbanks, Departmental Administrator. Tel. No. (508) 583-4500, X2479. FAX. (508) 586-0894. E-Mail Address: marie_fairbanks@http://hms.harvard.edu
Training Opportunities. Currently we have two fellows, two senior honors thesis students, a large number of junior faculty, and several full-time Research Assistants working in our laboratory. There are numerous opportunities for research training at all levels and we encourage interested undergraduates, graduate students, and fellows to join us in our research endeavors. Please visit us at our website: http://splweb.bwh.harvard.edu:8000/pages/projects/schiz/index.html
Representative Publications.
Dickey CC, McCarley RW, Voglmaier MM, Niznikiewicz MA, Seidman LJ, Hirayasu Y, Fischer, I, Teh EK, Rhoads, RV, Jakab, M, Kikinis R, Jolesz FA, Shenton ME. Schizotypal personality disorder and MRI abnormalities of temporal lobe gray matter. Biol Psychiatry 1999;45:1393-1402.
Dickey CC, Shenton ME, Hirayasu Y, Voglmaier MM, Niznikiewicz MA, Seidman LJ, Fischer IA, Fraone S, Sutton J, Teh EK, McCarley RW. Enlarged CSF volume in schizotypal personality disorder. Am J Psychiatry 2000;157:48-57.
Dickey CC, McCarley RW, Shenton ME. The brain in schizotypal personality disorder: a review of structural MRI and CT findings. Harvard Review Psychiatry 2001; In Press.
Shenton ME, Dickey CC, Frumin M, McCarley RW. A review of MRI findings in schizophrenia. Schizophr Res 2001;49:1-52.
Zahajsky J, Dickey CC, McCarley RW, Fischer IA, Nestor PG, Kikinis R, Shenton ME. A quantitative MR measure of the fornix in schizophrenia. Schizophr Res 2001;47:87-97.