Fractal dimension of cerebral cortical surface in schizophrenia and obsessive-compulsive disorder

Schizophrenia and obsessive-compulsive disorder (OCD) are assumed to be neurodevelopmental disorders. To examine the cortical patterns in the two disorders, three-dimensional fractal dimension (FD) of skeletonized cerebral cortical surface was estimated from magnetic resonance (MR) images of 50 patients with schizophrenia, 45 patients with OCD and 26 healthy normal controls. The schizophrenic group had a significantly smaller mean FD than OCD group, and the OCD group than normal controls. The FD revealed a significant interaction effect of group-by-hemisphere, and the FD asymmetry index distinguished the schizophrenic group from normal controls. In logistic regression models, the FD and CSF volume correctly classified 95.6% of the schizophrenics from the controls and 88.0% of the patients with OCD from the controls. In the control and schizophrenic groups, the FD was not associated with any of tissue volume measures. In the OCD group, however, the FD was significantly correlated with gray matter tissue volume and intracranial volume (ICV). The results of the present study suggest that three-dimensional FD of cortical surface may be a sensitive indicator for investigation of the structural brain abnormalities in mental disorders, especially those developmentally disturbed. Further studies to explore regional FD changes in mental disorders and clinical implications of the FD including diagnostic value should be performed in the future.

Sex differences in the human corpus callosum: diffusion tensor imaging study

In order to assess underlying structural differences between the male and female corpus callosum, the fractional anisotropy and volume of the corpus callosum, and also its T1 signal intensity, were measured. The corpus callosum of the 15 normal women and 15 normal men was drawn on the mid-sagittal T1-weighted image, for determining its volume and signal intensity, and this region of interest was projected onto the coregistered fractional anisotropy image, in order to obtain the value for the corpus callosum. We found increased T1 signal intensity and decreased fractional anisotropy in the female corpus callosum, as compared with that of the male. Despite the long-standing debates, the corpus callosum remains a region of sex differences.

Gray matter abnormalities in paranoid schizophrenia and their clinical correlations

Numerous imaging studies have shown structural brain abnormalities in schizophrenia. Recently, voxel-based morphometry enabled whole brain analysis beyond the regions of interest (ROI). Regional gray matter concentrations of magnetic resonance (MR) images from 35 patients with paranoid schizophrenia were compared with those from 35 age- and sex-matched controls, and their clinical correlations were explored using voxel-based morphometry. Gray matter concentrations in the patients were significantly reduced in the left insular and dorsolateral prefrontal regions, and bilaterally in the medial frontal, anterior cingulate, inferior frontal and superior temporal regions. On the other hand, gray matter concentrations in the bilateral cerebellum and right striatum were significantly increased in the patients compared with controls. A negative correlation between the score for the severity of 'lack of insight and judgment' and gray matter concentrations in the left posterior and right anterior cingulate and bilateral inferior temporal regions including the lateral fusiform gyri was found. These results suggest the important roles of the paralimbic structures in the pathophysiology of schizophrenia and the involvement of the perceptual and monitoring systems in the mechanism of insight.

Deformable model with surface registration for hippocampal shape deformity analysis in schizophrenia

Changes to the hippocampal structure have been reported as consistent structural abnormalities in schizophrenic patients and have been related to the learning and memory deficits in such patients. Although many magnetic resonance (MR) imaging studies have focused on the hippocampal volume, local structural changes were difficult to discriminate from normal neuroanatomical variations. 3D shape deformation analysis of the brain structure may reflect localized schizophrenic abnormalities. A deformable model, evolved from the ellipsoid to hippocampal surface, with 2562 vertexes, was developed to analyze the left and right hippocampus shapes in 22 schizophrenic patients and 22 healthy age and gender matched controls. One of the most critical issues in the shape analysis is the determination of homologous points between two objects. To determine more accurate corresponding points, an alignment procedure, consisting of coarse and fine steps, following a deformation process, was applied. The performance of the alignment process was tested using artificial data, to get the alignment error to within 3 degrees for each angle. A volume analysis indicated the hippocampal volume to be bilaterally reduced in schizophrenic patients compared to the normal controls, with a shape analysis showing a deformity pattern of the hippocampal surface. Bilateral inward deformities in the anterior and posterior hippocampus and a unilateral outward deformity in the right anterior hippocampus were observed, respectively.

Association between EEG alpha power and visuospatial function in obsessive-compulsive disorder

The purpose of the present paper was to determine if frontal activity, measured as electroencephalogram alpha power, correlates with visuospatial functions in obsessive-compulsive disorder (OCD). Electroencephalography and the Rey-Osterrieth Complex Figure Test (RCFT) were performed on 23 patients meeting the Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) OCD criteria. After quantitatively analyzing EEG recordings taken over the frontal, temporal, parietal and occipital regions (F1, F2, T3, T4, P3, P4, O1 and O2), the log transformed absolute power values of the alpha frequencies of the regions were regressed with each RCFT index (copy, immediate recall and delayed recall score). On the frontal region (F1, F2), the RCFT copy score was found to be correlated with the alpha power with regression coefficients that had different directions according to hemisphere (F1, 5.62; F2, -5.26). The result that visuo-constructional ability represented by the RCFT copy score correlated with frontal activation as measured by decreased alpha power, supports the opinion that visuospatial dysfunction in OCD is not in the visuospatial memory per se but rather that it is mediated by executive function deficit. The opposite correlation directions indicate that greater left frontal activation correlates with a poorer RCFT copy score and that greater right frontal activation correlates with a better copy score. These relationships provide indirect evidence of the possibility that the main pathology of OCD is located in the left hyperfrontality and that the right hyperfrontality of OCD occurs by a compensatory mechanism.

Deficits of Organizational Strategy and Visual Memory in Obsessive-Compulsive Disorder

This study was conducted to investigate the deficits of organizational strategy and visual memory in obsessive-compulsive disorder (OCD). Thirty OCD patients and 30 healthy controls aged 20-35 years participated. The Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, Wechsler Adult Intelligence Scale, and Rey-Osterrieth Complex Figure (ROCF) test were administered to participants. The authors scored ROCF performances using the Boston Qualitative Scoring System. The OCD patients showed poorer planning ability and higher fragmentation than did healthy controls when copying the ROCF, and they showed even poorer performances in the immediate and delayed recall conditions. The authors found that the Organization score in the copy condition mediated the difference between the OCD group and the healthy group in immediate recall. The direct effect of diagnosis (OCD or healthy) on the immediate recall condition of the ROCF was also significant. This study indicates that people with OCD have poor memory function and organizational deficits.

N-methyl-D-aspartate receptor in working memory impairments in schizophrenia: event-related potential study of late stage of working memory process

Working memory (WM) deficit in schizophrenic patients has been well established. Still, underlying biological substrate of the impairment is not clear. Among neurotransmitter hypotheses of schizophrenia, N-methyl-D-aspartate (NMDA) receptor model is mostly supported, considering that NMDA receptor antagonist can elicit both psychosis and cognitive impairment observed in schizophrenic patients. In current study, to test the neuropsychological and the electrophysiological effects of NMDA receptor in WM, event-related potentials (ERPs) of Sternberg's short-term memory scanning task (SMST) were analyzed in 10 healthy subjects under intravenous administration of a subanesthetic dose of ketamine (0.65 mg/kg/h) or placebo (normal saline). Late positive component (LPC) of ERP was hypothesized to reflect later stage of WM. Brief Psychiatric Rating Scale score was significantly increased (t=-5.75, df=9, P<.001) and correct response rate was significantly decreased (t=2.21, df=9, P=.054) after ketamine administration. Neither reaction time nor LPC latency, which reflect memory scanning time, was changed. Amplitude of LPC was significantly reduced after ketamine administration (z=-2.31, number of observations=120, P=.021). In conclusion, NMDA receptor antagonist administration elicited WM deficit both in behavioral and electrophysiological level. Electrophysiological component reflecting later stage of WM was impaired by NMDA antagonist.

Optimized individual mismatch negativity source localization using a realistic head model and the Talairach coordinate system

The purpose of this study is to evaluate the difference between anatomical locations of mismatch negativity (MMN) generators using a realistic head model and the Talairach coordinate system. This was performed by dipole source analysis by using a high density 128 channel electroencephalography (EEG) acquisition system and the subjects' individual 3D magnetic resonance images (MRI) for the realistic head model, in 24 healthy subjects. For dipole source localization, both the Talairach coordinate system and the individual MRI realistic head models were used and location results were compared. The MMN generators were clearly localized in the superior temporal gyri, especially in Heschl's gyrus, according to each individual's structural MRI. Only 37.5% of subjects showed the same anatomical locations of the MMN generator in both hemispheres in the realistic head model and in Talairach coordinate system, but fifteen subjects (62.5%) didn't. This result indicates that individually registered functional locations are desirable for the precise localization of activated areas in functional imaging studies and that a brain coordinate system is needed which adequately accounts for ethnic differences.

Classification of frequency distributions of diagnostic criteria scores in twelve personality disorders by the curve fitting method

The purpose of the present study was to investigate whether each personality disorder (PD) has a different frequency distribution of diagnostic criteria, and to classify the distribution of each PD on the basis of shape by the curve fitting method. A total of 4740 male subjects in early adulthood completed the Korean version of the Personality Diagnostic Questionnaire (4th revision; PDQ-4+). The frequency distribution of scores in each PD was specified to the best fitted model by the curve estimation procedure. Twelve distributions of PD criteria were fitted to three types of curve models (quadratic, cubic, and logistic). The quadratic model included obsessive-compulsive and histrionic PD. The cubic model included borderline, narcissistic, avoidant, passive-aggressive, paranoid, and schizotypal PD. The logistic model contained dependent, depressive, schizoid, and antisocial PD. The results suggest that each PD has a different type of distribution and each distribution of PD might be classified to a specific curve model. Also, the results suggest that the issue of continuities between PD and the normal group could not be generalized to all PD, but should be considered individually for each PD.

Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever

Dengue shock syndrome (DSS) is a potentially lethal complication of dengue virus infection associated with hypotension and leakage of plasma water into the extravascular space. To determine whether the underlying pathophysiology of DSS is distinct from that in milder forms of the disease, we assessed microvascular permeability, by use of strain gauge plethysmography, in Vietnamese children with DSS (n=19), or dengue hemorrhagic fever (DHF) without shock (n=16), and in healthy control children (n=15). At admission and after fluid resuscitation, the mean coefficient of microvascular permeability (K(f)) for the patients with dengue was approximately 50% higher than that for the control patients (P=.02). There was no significant difference in K(f) between the 2 groups of patients with dengue; this suggests the same underlying pathophysiology. We hypothesize that in patients with DSS, the fluctuations in K(f) are larger than those in patients with DHF, which leads to short-lived peaks of markedly increased microvascular permeability and consequent hemodynamic shock.