Proton Magnetic Resonance Spectroscopic Imaging of Cortical Gray and White Matter in Schizophrenia

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Abstract
A WIDESPREAD deficit in the gross volume of cortical gray matter relative to age and head-size norms, with relative sparing of white matter, has been identified in patients with schizophrenia.1-8 The presence of a cortical gray matter deficit at first episode suggests that this brain abnormality occurs early in the illness, whereas its failure to be associated with the length of illness in patients with chronic disease1,3,4,9 suggests that patients with schizophrenia do not lose cortical gray matter any faster than is normal for aging.10 These features support a neurodevelopmental model11 in which a prenatal, perinatal, or early postnatal lesion is hypothesized to establish a vulnerability, later triggered by events (endogenous, environmental, or both) that give rise to the manifest illness. Such a process does not preclude subsequent neurodegenerative processes superimposed on the earlier neurodevelopmental insults in some, but not necessarily all, patients.

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