Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-22T07:05:12.296Z Has data issue: false hasContentIssue false
  • English
  • Français

Ventricular Enlargement in Schizophrenia

A Meta-analysis of Studies of the Ventricle:Brain Ratio (VBR)

Published online by Cambridge University Press:  02 January 2018

J. D. Van Horn  and
I. C. McManus
J. D. Van Horn*
Affiliation:
Department of Psychology, University College London, Gower Street, London WC1E 6BT
I. C. McManus
Affiliation:
Department of Psychiatry, St Mary's Hospital Medical School, Imperial College of Science, Technology and Medicine, Praed Street, London W2 1NY
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

Multivariate meta-analysis was performed on 39 studies of ventricular size in schizophrenia which used the ventricle:brain ratio (VBR). The size of the VBR was dependent both upon the date when studies were carried out (more recent studies showing a reduction in the difference between schizophrenics and controls), and upon the diagnostic criterion used in the studies. Methodological factors in study design seemed more important than the characteristics of the schizophrenic subjects, in determining the VBR. Our analysis suggests that there is a difference in VBR between schizophrenics and controls which would seem to be an indisputable characteristic of schizophrenia. However, the difference is smaller than has previously been thought, so that, although of undoubted theoretical interest in accounting for the aetiology of schizophrenia, it is probably too small to be of practical significance in diagnosis, or in the differentiation of subtypes.

Type
Papers
Information
The British Journal of Psychiatry , Volume 160 , Issue 5 , May 1992 , pp. 687 - 697
Copyright
Copyright © The Royal College of Psychiatrists, 1992 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1960) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Andreasen, N. C., Smith, M. R., Jacoby, C. G., et al (1982) Ventricular enlargement in schizophrenia: definition and prevalence. American Journal of Psychiatry, 139, 292–296.Google ScholarPubMed
Benes, F., Sunderland, P., Jones, B. D., et al (1982) Normal ventricles in young schizophrenics. British Journal of Psychiatry, 141, 90–93.CrossRefGoogle ScholarPubMed
Bishop, R. J., Golden, C. J., MacInnes, W. D., et al (1983) The BPRS in assessing symptom correlates of cerebral ventricular enlargement in acute and chronic schizophrenia. Psychiatry Research, 9, 225–231.Google Scholar
Boronow, J., Pickar, D., Ninan, P. T., et al (1985) Atrophy limited to the third ventricle in chronic schizophrenic patients. Archives of General Psychiatry, 42, 266–271.CrossRefGoogle Scholar
Bridge, T. P., Parker, E. S., Ingraham, L., et al (1985) Gender effects seen in the cerebral ventricular/brain ratio (VBR). Biological Psychiatry, 20, 1132–1136.CrossRefGoogle ScholarPubMed
Buckman, T. D., Kling, A. S., Eiduson, S., et al (1987) Glutathione peroxidase and CT scan abnormalities in schizophrenia. Biological Psychiatry, 22, 1349–1356.CrossRefGoogle ScholarPubMed
Cohen, J. & Cohen, P. (1983) Applied Multiple Regression: Correlational Analysis for the Behavioural Sciences (2nd edn). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
DeLisi, L. E., Goldin, L. R., Hamovit, J. R., et al (1986) A family study of the association of increased ventricular size with schizophrenia. Archives of General Psychiatry, 43, 148–153.CrossRefGoogle ScholarPubMed
Dewan, M. J., Pandurangi, A. K., Howard Lee, S., et al (1986) A comprehensive study of chronic schizophrenic patients; I. Quantitative computed tomography: cerebral density, ventricle and sulcal measures. Acta Psychiatrica Scandinavica, 73, 152–160.CrossRefGoogle ScholarPubMed
Farmer, A., Jackson, R., McGuffin, P., et al (1987) Cerebral ventricular enlargement in chronic schizophrenia: consistencies and contradictions. British Journal of Psychiatry, 150, 324–330.CrossRefGoogle ScholarPubMed
Feighner, J. P., Robins, E. & Guze, S. (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.CrossRefGoogle ScholarPubMed
Glass, G. V. (1977) Integrating findings: the meta-analysis of research. Review of Research in Education, 5, 351–379.Google Scholar
Goetz, K. L. & van Kammen, D. P. (1986) Computerized axial tomography scans and subtypes of schizophrenia: a review of the literature. Journal of Nervous and Mental Disease, 174, 31–41.CrossRefGoogle ScholarPubMed
Harvey, I., Williams, M., Toone, B. K., et al (1990) The ventricular brain ratio (VBR) in functional psychoses: the relationship of lateral ventricular and total intracranial size. Psychological Medicine, 20, 55–62.Google Scholar
Haug, J. O. (1962) Pneumoencephalographic studies in mental disease. Acta Psychiatrica Scandinavica (suppl. 165), 1–114.Google Scholar
Hedges, L. V. & Olkin, I. (1985) Statistical Methods for Meta-analysis. Orlando, Florida: Academic Press.Google Scholar
Hunter, J. E. & Schmidt, F. L. (1990) Methods of Meta-analysis. Newbury Park, California: Sage Publications.Google Scholar
Iacono, W. G., Smith, G. N., Moreau, M., et al (1988) Ventricular and sulcal size at the onset of schizophrenia. American Journal of Psychiatry, 145, 820–824.Google Scholar
Isherwood, I. (1979) Contrast enhancement in brain and body. In Medical Imaging: A Basic Course (ed. Kreel, L.), p. 89. Aylesbury, Buckinghamshire: HM & M Publishers Google Scholar
Jacobson, R. R., Turner, S. W., Baldy, R. E., et al (1985) Desitometric analysis of scans: important sources of artefact. Psychological Medicine, 15, 879–889.Google Scholar
Jernigan, T. L., Zatz, L. M., Moses, J. A., et al (1982) Computed tomography in schizophrenia and normal volunteers. Archives of General Psychiatry, 39, 765–770.CrossRefGoogle ScholarPubMed
Johnstone, E. C., Crow, T. J., Frith, C. D., et al (1976) Cerebral ventricular size and cognitive impairment in chronic schizophrenia. Lancet, 2, 924–926.Google Scholar
Kaiya, H., Uematsu, M., Ofuji, M., et al (1989) Computerized tomography in schizophrenia: familial versus non-familial forms of illness. British Journal of Psychiatry, 155, 444–450.CrossRefGoogle ScholarPubMed
Kelsoe, A. R., Cadet, J. L., Pickar, D., et al (1988) Quantitative neuroanatomy in schizophrenia: a controlled magnetic resonance imaging study. Archives of General Psychiatry, 45, 533–541.CrossRefGoogle ScholarPubMed
Kemali, D., Maj, M., Galderisi, S., et al (1987) Clinical, biological, and neurological features associated with ventricular enlargement in DSM–III schizophrenia disorder. Psychiatry Research, 21, 137–149.CrossRefGoogle Scholar
Kenny, D. A. (1979) Correlation and Causality. New York: John Wiley.Google Scholar
Kling, A. S., Metter, E. J., Riege, W. H., et al (1986) Comparison of PET measurement of local brain glucose metabolism and CAT measurement of brain atrophy in chronic schizophrenia and depression. American Journal of Psychiatry, 143, 175–180.Google ScholarPubMed
Kretschmer, E. (1945) Physique and Character. London: Kegan Paul, Trench, Trubner and Co.Google Scholar
Losonczy, M. F., Song, I. S., Mohs, R. C., et al (1986) Correlates of lateral ventricular size in chronic schizophrenia, I: Behavioral and treatment response measures. American Journal of Psychiatry, 143, 976–981.Google ScholarPubMed
Luchins, D. H., Lewine, R. R. J. & Meltzer, H. Y. (1984) Lateral ventricular size, psychopathology, and medication response in the psychoses. Biological Psychiatry, 19, 29–44.Google ScholarPubMed
Luchins, D. H. & Meltzer, H. Y. (1986) A comparison of CT findings in acute and chronic schizophrenia. Psychiatry Research, 17, 7–14.Google Scholar
Maser, J. D. & Keith, S. J. (1983) CT scans and schizophrenia-report on a workshop. Schizophrenia Bulletin, 9, 265–283.Google Scholar
Moscarelli, M., Cesana, B. M., Ciussani, S., et al (1989) Ventricle-brain ratio and alogia in 19 young patients with chronic negative and positive symptoms. American Journal of Psychiatry, 146, 257–258.Google Scholar
Nasrallah, H. A., Jacoby, C. G., McCalley-Whitters, M., et al (1982) Cerebral ventricular enlargement in subtypes of chronic schizophrenia. Archives of General Psychiatry, 39, 774–777.CrossRefGoogle ScholarPubMed
Nasrallah, H. A., Schwarzkopf, S. B., Olson, S. C., et al (1990) Gender differences in schizophrenia on MRI brain scans. Schizophrenia Bulletin, 16, 205–210.Google Scholar
Obiols-Llandrich, J. E., Ruscalleda, J. & Masferrer, M. (1986) Ventricular enlargement in young chronic schizophrenics. Acta Psychiatrica Scandinavica, 73, 42–44.CrossRefGoogle ScholarPubMed
Obiols, J. E., Marcos, T. & Salamero, M. (1987) Ventricular enlargement and neurological testing in schizophrenia. Acta Psychiatrica Scandinavica, 76, 199–202.CrossRefGoogle Scholar
Okasha, A. & Madkour, O. (1982) Cortical and central atrophy in schizophrenia. Acta Psychiatrica Scandinavica, 65, 29–34.CrossRefGoogle ScholarPubMed
Owen, M. J., Lewis, S. W. & Murray, R. M. (1989) Family history and ventricular enlargement in schizophrenia: a case control study. British Journal of Psychiatry, 154, 629–634.CrossRefGoogle ScholarPubMed
Pandurangi, A. K., Dewan, M. J., Lee, S. H., et al (1984) The ventricle system in chronic schizophrenic patients; a controlled computed tomography study. British Journal of Psychiatry, 144, 172–176.Google Scholar
Pearlson, G. D., Veroff, A. E. & McHugh, P. R. (1981) The use of computed tomography in psychiatry: recent applications to schizophrenia, manic-depressive illness and dementia syndromes. Johns Hopkins Medical Journal, 149, 194–202.Google Scholar
Pearlson, G. D., Garbacz, D. J., Breakley, W. R., et al (1984) Lateral ventricular enlargement associated with persistent unemployment and negative symptoms in both schizophrenia and bipolar disorder. Psychiatry Research, 12, 1–9.CrossRefGoogle ScholarPubMed
Raz, N., Raz, S. & Bigler, E. D. (1988) Ventriculomegaly in schizophrenia: the role of groups and the perils of dichotomous thinking. Psychiatry Research, 26, 245–248.CrossRefGoogle ScholarPubMed
Raz, S., Raz, R. & Bigler, E. D. (1988) Ventriculomegaly in schizophrenia: is the choice of control group important? Psychiatry Research, 24, 71–77.CrossRefGoogle Scholar
Raz, S. & Raz, N. (1990) Structural brain abnormalities in the major psychoses: a quantitative review of the evidence from computerized imaging. Psychological Review, 108, 93–108.Google ScholarPubMed
Reveley, A. M., Reveley, M. A., Clifford, C. A., et al (1982) Cerebral ventricular size in twins discordant for schizophrenia. Lancet, i, 540.CrossRefGoogle Scholar
Reveley, A. M. & Reveley, M. A. (1983) Aqueduct stenosis and schizophrenia. Journal of Neurology, Neurosurgery, and Psychiatry, 46, 18.CrossRefGoogle ScholarPubMed
Reveley, A. M., Reveley, M. A. & Murray, R. M. (1984) Cerebral ventricular enlargement in non-genetic schizophrenia: a controlled twin study. British Journal of Psychiatry, 144, 89–93.CrossRefGoogle ScholarPubMed
Reveley, A. M., Reveley, M. A., Chitkara, B., et al (1984) The genetic basis of cerebral ventricular enlargement. Psychiatry Research, 13, 261–266.CrossRefGoogle Scholar
Reveley, M. A. (1985) CT scans in schizophrenia. British Journal of Psychiatry, 146, 367–371.Google Scholar
Rieder, R. O., Mann, L. S., Weinberger, D. R., et al (1983) Computed tomographic scans in patients with schizophrenia, schizoaffective and bipolar affective disorder. Archives of General Psychiatry, 40, 735–739.Google Scholar
Roberts, M. A. & Caird, F. I. (1976) Computerized tomography and intellectual impairment in the elderly. Journal of Neurology, Neurosurgery, and Psychiatry, 39, 986.CrossRefGoogle ScholarPubMed
Ron, M. (1983) The alcoholic brain: CT scan and psychological findings. Psychological Medicine (suppl. 3).Google Scholar
Rosenthal, R. (1984) Meta-analytic Procedures for Social Research. Beverly Hills, California: Sage.Google Scholar
Rossi, A., Stratta, P., Casacchia, M., et al (1987) Age and duration of illness as predictors ventricular brain ratio (VBR) size in chronic schizophrenic patients. Acta Psychiatrica Scandinavica, 76, 256–260.CrossRefGoogle ScholarPubMed
Rossi, A., Stratta, P., Gallucci, M., et al (1988) Brain morphology in schizophrenia by magnetic resonance imaging (MRI). Acta Psychiatrica Scandinavica, 77, 741–745.Google Scholar
Rossi, A., Stratta, P., Gallucci, M., et al (1989) Quantification of corpus callosum and ventricles in schizophrenia with nuclear magnetic resonance imaging: a pilot study. American Journal of Psychiatry, 146, 99–101.Google ScholarPubMed
Scottish Schizophrenia Research Group, MacDonald, H. L. & West, J. J. (1989) The Scottish first episode schizophrenia study: VI computerized tomography brain scans in patients and controls. British Journal of Psychiatry, 154, 492–498.CrossRefGoogle ScholarPubMed
Schultz, S. C., Koller, M. M., Kishore, P. R., et al (1983) Ventricular enlargement in teenage patients with schizophrenia spectrum disorder. American Journal of Psychiatry, 140, 1592–1595.Google Scholar
Sheldon, W. H. (1940) The Varieties of Human Physique: An Introduction to Constitutional Psychology. New York: Harper & Brothers.Google Scholar
Shelton, R. C., Karson, C. N., Doran, A. R., et al (1988) Cerebral structural pathology in schizophrenia: Evidence for a selective prefrontal cortical defect. American Journal of Psychiatry, 145, 154–163.Google Scholar
Shima, S., Kanba, S., Masuda, Y., et al (1985) Normal ventricles in chronic schizophrenics. Acta Psychiatrica Scandinavica, 71, 25–29.Google Scholar
Smeraldi, E., Gambini, O., Bellodi, L., et al (1987) Combined measure of smooth pursuit eye movements and ventricle-brain ratio in schizophrenic disorders. Psychiatry Research, 19, 294–301.Google Scholar
Smith, R. C., Baumgartner, R., Ravichandran, G. K., et al (1985) Lateral ventricular enlargement and clinical response in schizophrenia. Psychiatry Research, 14, 241–253.CrossRefGoogle ScholarPubMed
Smith, G. N. & Iacono, W. G. (1986) Lateral ventricular size in schizophrenia and choice of control group. Lancet, i, 1450.Google Scholar
Smith, G. N. & Iacono, W. G. (1988) Ventricular size in schizophrenia: importance of choice of control subjects. Psychiatry Research, 26, 241–243.CrossRefGoogle ScholarPubMed
Smith, G. N., Iacono, W. G., Moreau, M., et al (1988) Choice of comparison group and findings of computerized tomography in schizophrenia. British Journal of Psychiatry, 153, 667–674.CrossRefGoogle ScholarPubMed
Spitzer, R. I., Endicott, J. & Robins, E. (1975) Research Diagnostic Criteria (instrument 58). New York: New York State Psychiatric Institute.Google Scholar
Storey, P. B. (1966) Lumbar air encephalography in chronic schizophrenia: a controlled study. British Journal of Psychiatry, 112, 135–144.Google Scholar
Suddath, R. L., Christison, G. W., Torrey, E. F., et al (1990) Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia. New England Journal of Medicine, 322, 789–794.CrossRefGoogle ScholarPubMed
Synek, V. & Reuben, J. R. (1976) The ventricle-brain ratio using planimetric measurements of EMI scans. British Journal of Radiology, 49, 233–237.CrossRefGoogle Scholar
Synek, V., Reuben, J. R. & Du Boulay, G. H. (1976) Comparing Evan's index and computerized axial tomography in assessing relationship of ventricular size to brain size. Neurology, 26, 231–233.Google Scholar
Turner, S. W., Toone, B. K. & Brett-Jones, J. R. (1986) Computerized tomographic scan changes in early schizophrenia - preliminary findings. Psychological Medicine, 16, 219–225.Google Scholar
Weinberger, D. R., Torrey, E. F., Neophytides, A. N., et al (1979) Lateral cerebral ventricular enlargement in chronic schizophrenia. Archives of General Psychiatry, 36, 735–739.Google Scholar
Weinberger, D. R., DeLisi, L. E., Perman, G. P., et al (1982) Computed tomography in schizophreniform disorder and other acute psychiatric disorders. Archives of General Psychiatry, 39, 778–783.Google Scholar
Weinberger, D. R., Torrey, E. F., Neophytides, A. N., et al (1983) Structural abnormalities in the cerebral cortex of chronic schizophrenic patients: a controlled CT study. Biological Psychiatry, 18, 1133–1140.Google Scholar
Williams, A. O., Reveley, M. A., Kolakowska, T., et al (1985) Schizophrenia with good and poor outcome: II. Cerebral ventricular size and its clinical significance. British Journal of Psychiatry, 146, 239–246.CrossRefGoogle ScholarPubMed
Zatz, L. M. & Jernigan, T. L. (1983) The ventricular-brain ratio on computed tomography scans: validity and proper use. Psychiatry Research, 8, 207–214.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.