Neuroanatomical differences between familial and sporadic schizophrenia and their parents: an optimized voxel-based morphometry study

Evidence for increased DNA damage repair in the postmortem brain of the high stress-response group of schizophrenia

Background

Schizophrenia (SZ) is a disorder diagnosed by specific symptoms and duration and is highly heterogeneous, clinically and pathologically. Although there are an increasing number of studies on the association between genetic and environmental factors in the development of SZ, the actual distribution of the population with different levels of influence of these factors has not yet been fully elucidated. In this study, we focused on stress as an environmental factor and stratified SZ based on the expression levels of stress-responsive molecules in the postmortem prefrontal cortex.

Methods

We selected the following stress-responsive molecules: interleukin (IL) -1β, IL-6, IL-10, tumor necrosis factor-α, interferon-γ, glucocorticoid receptor, brain-derived neurotrophic factor, synaptophysin, S100 calcium-binding protein B, superoxide dismutase, postsynaptic density protein 95, synuclein, apolipoprotein A1 (ApoA1), ApoA2, and solute carrier family 6 member 4. We performed RNA sequencing in the prefrontal gray matter of 25 SZ cases and 21 healthy controls and conducted a hierarchical cluster analysis of SZ based on the gene expression levels of stress-responsive molecules, which yielded two clusters. After assessing the validity of the clusters, they were designated as the high stress-response SZ group and the low stress-response SZ group, respectively. Ingenuity Pathway Analysis of differentially expressed genes (DEGs) between clusters was performed, and Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining was conducted on four cases each in the high and low stress-response SZ groups to validate DNA damage.

Results

We found higher prevalence of family history of SZ in the low stress-response SZ group (0/3 vs. 5/4, p = 0.04). Pathway analysis of DEGs between clusters showed the highest enrichment for DNA double-strand break repair. TUNEL staining showed a trend toward a lower percentage of TUNEL-positive cells in the high stress-response SZ group.

Conclusion

Our results suggest that there are subgroups of SZ with different degrees of stress impact. Furthermore, the pathophysiology of these subgroups may be associated with DNA damage repair. These results provide new insights into the interactions and heterogeneity between genetic and environmental factors.

Aberrant brain structure in patients with schizophrenia and violence: A meta-analysis

Previous studies have indicated that schizophrenia is associated with an increased risk of violence, which may constitute a public health concern, leading to poor treatment outcomes and stigmatization of patients. Investigating brain structural features of violence in schizophrenia could help us understand its specific pathogenesis and find effective biomarkers. Our study aimed at identifying reliable brain structural changes associated with violence in patients with schizophrenia by conducting a meta-analysis and meta-regression of magnetic resonance imaging studies. Specific brain changes in patients with schizophrenia and violence (VSZ) were studied, compared with patients with schizophrenia and violence (VSZ), patients with non-violent schizophrenia (NVSZ), and individuals with a history of violence only and health controls. Primary outcomes revealed that there was no significant difference of gray matter volume between patients with VSZ and patient with NVSZ. Compared with controls, patients with VSZ exhibited decreased gray matter volume in the insula, the superior temporal gyrus (STG), the left inferior frontal gyrus, the left parahippocampus, and the right putamen. Compared with individuals with a history of violence only, patients with VSZ exhibited decreased volume in the right insula and the right STG. Meta-regression analysis revealed a negative correlation between the duration of schizophrenia and the volume of the right insula in patients with VSZ. These findings may suggest a shared neurobiological basis for both violence and psychiatric symptoms. The impaired frontotemporal-limbic network may serve as a neurobiological basis for higher prevalence of violent behaviour in patients with schizophrenia. However, it is important to note that these changes are not unique to patients with VSZ. Further investigation is needed to explore the neural mechanism that drive the interaction between violent behaviour and specific aggression-related dimensions of schizophrenia.

Clinical correlates of regional gray matter volumes in schizophrenia: A structural magnetic resonance imaging study

OBJECTIVES

The objective of this study is to investigate the correlation between the regional gray matter volumes and length of Para Cingulate Sulcus (PCS) with the clinical profile of patients with schizophrenia.

MATERIALS AND METHODS

In this hospital-based, cross-sectional study, thirty consecutive in-patients diagnosed with schizophrenia and equal number of healthy volunteers matched for age- and sex- were recruited as controls. Detailed clinical assessment and magnetic resonance imaging (MRI) of the brain were carried out within 2 days for controls and within 2 weeks of hospitalization for patients. The Positive and Negative Syndrome Scale and Montreal Cognitive Assessment were applied to schizophrenia patients to assess symptoms and cognitive function, respectively.

RESULTS

Schizophrenia patients had significant volume deficit in bilateral amygdalae, bilateral superior temporal gyri, anterior cingulate cortex and bilateral hippocampi, along with a highly significant reduction in the length of right PCS. Schizophrenia patients with the duration of untreated psychosis (DUP) of 6-12 months showed a significantly greater volume of the right superior temporal gyrus (STG). First-episode schizophrenia patients had a significant reduction in the length of the left PCS. The volume of bilateral superior temporal gyri in schizophrenia patients showed a significant direct correlation with positive symptoms and an inverse correlation with negative symptoms.

CONCLUSION

Schizophrenia patients have significant volume deficit in some brain regions. DUP of 6-12 months is associated with significantly greater volume of the right STG. First-episode schizophrenia patients have a significant reduction in the length of the left PCS. In schizophrenia patients, the volume of bilateral superior temporal gyri showed a significant direct correlation with the positive symptoms and an inverse correlation with the negative symptoms.

Abnormal Brain Structure Morphology in Early-Onset Schizophrenia

With less exposure to environmental and medication influences, individuals with early-onset schizophrenia (EOS) may provide valuable evidence to study the pathogenesis and phenotypic pattern of schizophrenia.T1-weighted magnetic resonance images were collected in 60 individuals with EOS and 40 healthy controls. Voxel-based morphometry and surface-based morphometry analyzes were performed. Gray matter volume, cortical thickness and cortical surface area were compared between the EOS and healthy controls and among schizophrenia subgroups (with or without family history of schizophrenia). Compared with healthy controls, the EOS group had reduced gray matter volume in the bilateral middle temporal gyrus and reduced cortical thickness in several brain regions. The sporadic early onset schizophrenia and the familial early onset schizophrenia showed different brain structure morphology. These findings suggest that abnormal brain structure morphology, especially in the temporal and frontal lobes, may be an important pathophysiological feature of EOS.

Temporal-thalamic and cingulo-opercular connectivity in people with schizophrenia

A growing body of research has suggested that people with schizophrenia (SZ) exhibit altered patterns of functional and anatomical brain connectivity. For example, many previous resting state functional connectivity (rsFC) studies have shown that, compared to healthy controls (HC), people with SZ demonstrate hyperconnectivity between subregions of the thalamus and sensory cortices, as well as hypoconnectivity between subregions of the thalamus and prefrontal cortex. In addition to thalamic findings, hypoconnectivity between cingulo-opercular brain regions thought to be involved in salience detection has also been commonly reported in people with SZ. However, previous studies have largely relied on seed-based analyses. Seed-based approaches require researchers to define a single a priori brain region, which is then used to create a rsFC map across the entire brain. While useful for testing specific hypotheses, these analyses are limited in that only a subset of connections across the brain are explored. In the current manuscript, we leverage novel network statistical techniques in order to detect latent functional connectivity networks with organized topology that successfully differentiate people with SZ from HCs. Importantly, these techniques do not require a priori seed selection and allow for whole brain investigation, representing a comprehensive, data-driven approach to determining differential connectivity between diagnostic groups. Across two samples, (Sample 1: 35 SZ, 44 HC; Sample 2: 65 SZ, 79 HC), we found evidence for differential rsFC within a network including temporal and thalamic regions. Connectivity in this network was greater for people with SZ compared to HCs. In the second sample, we also found evidence for hypoconnectivity within a cingulo-opercular network of brain regions in people with SZ compared to HCs. In summary, our results replicate and extend previous studies suggesting hyperconnectivity between the thalamus and sensory cortices and hypoconnectivity between cingulo-opercular regions in people with SZ using data-driven statistical and graph theoretical techniques.

Maternal cerebellar gray matter volume is associated with daughters' psychotic experience

AIM

A substantial portion of children and adolescents show subthreshold psychotic symptoms called psychotic experience (PE). Because PE shares its biological and environmental risk factors with psychotic spectrum disorders, parental neuroanatomical variation could reflect a heritable biological underpinning of PE that may predict an offspring's PE.

METHODS

A total of 94 participants from 35 families without a diagnosis of major neuropsychiatric disorders were examined, including 14 mother-daughter, 17 mother-son, 12 father-daughter, and 16 father-son dyads. An offspring's PE was assessed with the Atypicality subscale of the Behavior Assessment System for Children - 2nd Edition, Self-Report of Personality form (BASCaty). We examined correlations between voxel-by-voxel parental gray matter volume and their offspring's BASCaty score.

RESULTS

Maternal cerebellar gray matter volume using voxel-based morphometry was positively correlated with their daughters' BASCaty scores. The findings were significant in a more robust approach using cerebellum-specific normalization known. We did not find significant correlation between paternal gray matter volume and BASCaty scores or between offspring gray matter volumes and their BASCaty scores.

CONCLUSION

Expanding upon parent-of-origin effects in psychosis, maternal neuroanatomical variation was associated with daughters' PE. The nature of this sex-specific intergenerational effect is unknown, but maternally transmitted genes may relate cerebellum development to PE pathogenesis.

Brain structural correlates of familial risk for mental illness: a meta-analysis of voxel-based morphometry studies in relatives of patients with psychotic or mood disorders

Schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD) are heritable psychiatric disorders with partially overlapping genetic liability. Shared and disorder-specific neurobiological abnormalities associated with familial risk for developing mental illnesses are largely unknown. We performed a meta-analysis of structural brain imaging studies in relatives of patients with SCZ, BD, and MDD to identify overlapping and discrete brain structural correlates of familial risk for mental disorders. Search for voxel-based morphometry studies in relatives of patients with SCZ, BD, and MDD in PubMed and Embase identified 33 studies with 2292 relatives and 2052 healthy controls (HC). Seed-based d Mapping software was used to investigate global differences in gray matter volumes between relatives as a group versus HC, and between those of each psychiatric disorder and HC. As a group, relatives exhibited gray matter abnormalities in left supramarginal gyrus, right striatum, right inferior frontal gyrus, left thalamus, bilateral insula, right cerebellum, and right superior frontal gyrus, compared with HC. Decreased right cerebellar gray matter was the only abnormality common to relatives of all three conditions. Subgroup analyses showed disorder-specific gray matter abnormalities in left thalamus and bilateral insula associated with risk for SCZ, in left supramarginal gyrus and right frontal regions with risk for BD, and in right striatum with risk for MDD. While decreased gray matter in right cerebellum might be a common brain structural abnormality associated with shared risk for SCZ, BD, and MDD, regional gray matter abnormalities in neocortex, thalamus, and striatum appear to be disorder-specific.

Genetic associations and expression of extra-short isoforms of disrupted-in-schizophrenia 1 in a neurocognitive subgroup of schizophrenia

Disrupted-in-schizophrenia 1 (DISC1) was reported to be associated with schizophrenia. In a previous study, we found significant association with schizophrenia patients with deficient sustained attention assessed by continuous performance test (CPT). This study aimed to identify risk polymorphisms in this specific neurocognitive subgroup and investigate the expression of different isoforms of DISC1. A total of 83 genetic variants were identified through direct sequencing in 50 controls and 100 schizophrenia patients. Fourteen variants were genotyped in 600 controls and 912 patients. Patients were subgrouped by familial loading (multiplex or simplex) and performance on CPT. The frequency of AA genotype of rs11122324 at the 3'-UTR of Es and Esv1 isoforms and of rs2793091 at intron 4 were significantly higher in multiplex schizophrenia patients than those in controls (corrected p < 0.05). In further subgrouping, the frequency of AA genotype of the two SNPs were significantly higher in multiplex schizophrenia patients with deficient sustained attention than those in controls (corrected p < 0.005). The mRNA expression levels of two extra-short isoforms (Es and Esv1) in the EBV-transformed lymphocytes of schizophrenia were significantly higher than those of controls. Luciferase reporter assays demonstrated that the A-allele of rs11122324 significantly upregulated DISC1 extra-short isoforms transcription compared with the G-allele. We found two SNPs (rs11122324 and rs2793091) of DISC1 may be specifically associated with multiplex schizophrenia patients with deficient sustained attention. The SNP rs11122324 may be a risk polymorphism, which may have functional influence on the transcription of Es and Esv1 through increasing their expression.

Schizotypal traits, neurocognition, and paternal age in unaffected first degree relatives of patients with familial or sporadic schizophrenia

Studies comparing cognitive processes between familial and sporadic schizophrenia have yielded inconsistent findings. In this study we examined differences in neurocognition and schizotypal traits in unaffected relatives of schizophrenia-spectrum patients with either the familial (multiplex) or the sporadic (simplex) subtype of the disorder, taking paternal age at birth into consideration. Simplex (n = 65; SR), multiplex (n = 35; MR) relatives and controls (n = 114) were compared on several cognitive functions and schizotypal traits; between-group differences were evaluated with and without including paternal age in the analyses. SR and MR had higher negative and paranoid traits compared with controls, but paternal age abolished the differences between the SR and control groups. When taking into account schizotypal traits and participants' age, controls outperformed MR in strategy formation and set-shifting and SR in psychomotor speed, set-shifting and executive working memory. After including paternal age in the analyses, controls outperformed MR in strategy formation, working memory and executive working memory and both groups in psychomotor speed and set-shifting. These findings suggest that multiplex relatives present with a "riskier" personality and cognitive profile when considering the effects of paternal age. Nevertheless, simplex relatives are impaired in fundamental cognitive processes, thus highlighting the detrimental effects of paternal age on neurocognition.

Performance of Verbal Fluency as an Endophenotype in Patients with Familial versus Sporadic Schizophrenia and Their Parents

What’s the neurocognitive deficit as an endophenotype to familial schizophrenia? Here, we investigate the neurocognitive endophenotype in first-episode patients with familial schizophrenia (FS) and sporadic schizophrenia (SS), and their parents. 98 FS patients and their 105 parents; 190 SS patients and their 207 parents; 195 controls matched with patients, and 190 controls matched with the patients’ parents, were assessed with the short version of the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC), the immediate and delayed logical memory tests from the Wechsler Memory Scale-Revised in China (WMS-RC), the Verbal Fluency Test (VFT), the Trail Making Test Parts A and B-Modified (TMA, TMB-M), and the Modified Wisconsin Card Sorting Test (WCST-M). The results showed that with age, gender, and education as covariates, after controlling for false discovery rates, the FS group and their parent group performed worse than the SS group and their parent group on VFT. No significant differences were found for other neurocognitive tests between the FS and SS patient groups, and their respective parent groups. Our findings suggest the patients with familial and sporadic schizophrenia and their respective parent groups may have a different genetic predisposition in relation to a cognitive endophenotype.

Discriminative analysis of schizophrenia using support vector machine and recursive feature elimination on structural MRI images

Structural abnormalities in schizophrenia (SZ) patients have been well documented with structural magnetic resonance imaging (MRI) data using voxel-based morphometry (VBM) and region of interest (ROI) analyses. However, these analyses can only detect group-wise differences and thus, have a poor predictive value for individuals. In the present study, we applied a machine learning method that combined support vector machine (SVM) with recursive feature elimination (RFE) to discriminate SZ patients from normal controls (NCs) using their structural MRI data. We first employed both VBM and ROI analyses to compare gray matter volume (GMV) and white matter volume (WMV) between 41 SZ patients and 42 age- and sex-matched NCs. The method of SVM combined with RFE was used to discriminate SZ patients from NCs using significant between-group differences in both GMV and WMV as input features. We found that SZ patients showed GM and WM abnormalities in several brain structures primarily involved in the emotion, memory, and visual systems. An SVM with a RFE classifier using the significant structural abnormalities identified by the VBM analysis as input features achieved the best performance (an accuracy of 88.4%, a sensitivity of 91.9%, and a specificity of 84.4%) in the discriminative analyses of SZ patients. These results suggested that distinct neuroanatomical profiles associated with SZ patients might provide a potential biomarker for disease diagnosis, and machine-learning methods can reveal neurobiological mechanisms in psychiatric diseases.

Distinct disruptions of resting-state functional brain networks in familial and sporadic schizophrenia

Clinical and brain structural differences have been reported between patients with familial and sporadic schizophrenia; however, little is known about the brain functional differences between the two subtypes of schizophrenia. Twenty-six patients with familial schizophrenia (PFS), 26 patients with sporadic schizophrenia (PSS) and 26 healthy controls (HC) underwent a resting-state functional magnetic resonance imaging. The whole-brain functional network was constructed and analyzed using graph theoretical approaches. Topological properties (including global, nodal and edge measures) were compared among the three groups. We found that PFS, PSS and HC exhibited common small-world architecture of the functional brain networks. However, at a global level, only PFS showed significantly lower normalized clustering coefficient, small-worldness, and local efficiency, indicating a randomization shift of their brain networks. At a regional level, PFS and PSS disrupted different neural circuits, consisting of abnormal nodes (increased or decreased nodal centrality) and edges (decreased functional connectivity strength), which were widely distributed throughout the entire brain. Furthermore, some of these altered network measures were significantly correlated with severity of psychotic symptoms. These results suggest that familial and sporadic schizophrenia had segregated disruptions in the topological organization of the intrinsic functional brain network, which may be due to different etiological contributions.

Voxel-based morphometry for separation of schizophrenia from other types of psychosis in first episode psychosis

BACKGROUND

Schizophrenia is a psychiatric disorder which involves distortions in thought and perception, blunted affect, and behavioural disturbances. The longer psychosis goes unnoticed and untreated, the more severe the repercussions for relapse and recovery. There is some evidence that early intervention services can help, and diagnostic techniques that could contribute to early intervention may offer clinical utility in these situations. The index test being evaluated in this review is the structural magnetic resonance imaging (MRI) analysis technique known as voxel-based morphometry (VBM) that estimates the distribution of grey matter tissue volume across several brain regions. This review is an exploratory examination of the diagnostic 'potential' of VBM for use as an additional tool in the clinical examination of patients with first episode psychosis to establish whether an individual will progress on to developing schizophrenia as opposed to other types of psychosis.

OBJECTIVES

To determine whether VBM applied to the brain can be used to differentiate schizophrenia from other types of psychosis in participants who have received a clinical diagnosis of first episode psychosis.

SEARCH METHODS

In December 2013, we updated a previous search (May 2012) of MEDLINE, EMBASE, and PsycInfo using OvidSP.

SELECTION CRITERIA

We included retrospective and prospective studies that consecutively or randomly selected adolescent and adult participants (< 45 years) with a first episode of psychosis; and that evaluated the diagnostic accuracy of VBM for differentiating schizophrenia from other psychoses compared with a clinical diagnosis made by a qualified mental health professional, with or without the use of standard operational criteria or symptom checklists. We excluded studies in children, and in adult participants with organic brain disorders or who were at high risk for schizophrenia, such as people with a genetic predisposition.

DATA COLLECTION AND ANALYSIS

Two review authors screened all references for inclusion. We assessed the quality of studies using the QUADAS-2 instrument. Due to a lack of data, we were not able to extract 2 x 2 data tables for each study nor undertake any meta-analysis.

MAIN RESULTS

We included four studies with a total of 275 participants with first episode psychosis. VBM was not used to diagnose schizophrenia in any of the studies, instead VBM was used to quantify the magnitude of differences in grey matter volume. Therefore, none of the included studies reported data that could be used in the analysis, and we summarised the findings narratively for each study.

AUTHORS' CONCLUSIONS

There is no evidence to currently support diagnosing schizophrenia (as opposed to other psychotic disorders) using the pattern of brain changes seen in VBM studies in patients with first episode psychosis. VBM has the potential to discriminate between diagnostic categories but the methods to do this reliably are currently in evolution. In addition, the lack of applicability of the use of VBM to clinical practice in the studies to date limits the usefulness of VBM as a diagnostic aid to differentiate schizophrenia from other types of psychotic presentations in people with first episode of psychosis.

Grey matter, an endophenotype for schizophrenia? A voxel-based morphometry study in siblings of patients with schizophrenia

BACKGROUND

Grey matter, both volume and concentration, has been proposed as an endophenotype for schizophrenia given a number of reports of grey matter abnormalities in relatives of patients with schizophrenia. However, previous studies on grey matter abnormalities in relatives have produced inconsistent results. The aim of the present study was to examine grey matter differences between controls and siblings of patients with schizophrenia and to examine whether the age, genetic loading or subclinical psychotic symptoms of selected individuals could explain the previously reported inconsistencies.

METHODS

We compared the grey matter volume and grey matter concentration of healthy siblings of patients with schizophrenia and healthy controls matched for age, sex and education using voxel-based morphometry (VBM). Furthermore, we selected subsamples based on age (< 30 yr), genetic loading and subclinical psychotic symptoms to examine whether this would lead to different results.

RESULTS

We included 89 siblings and 69 controls in our study. The results showed that siblings and controls did not differ significantly on grey matter volume or concentration. Furthermore, specifically selecting participants based on age, genetic loading or subclinical psychotic symptoms did not alter these findings.

LIMITATIONS

The main limitation was that subdividing the sample resulted in smaller samples for the subanalyses. Furthermore, we used MRI data from 2 different scanner sites.

CONCLUSION

These results indicate that grey matter measured through VBM might not be a suitable endophenotype for schizophrenia.

Advances in neuroimaging research of schizophrenia in China

SUMMARY

Since Hounsfield's first report about X-ray computed tomography (CT) in 1972, there has been substantial progress in the application of neuroimaging techniques to study the structure, function, and biochemistry of the brain. This review provides a summary of recent research in structural and functional neuroimaging of schizophrenia in China and four tables describing all of the relevant studies from mainland China. The first research report using neuroimaging techniques in China dates back to 1983, a study that reported encephalatrophy in 30% of individuals with schizophrenia. Functional neuroimaging research in China emerged in the 1990s and has undergone rapid development since. Recently, structural and functional brain networks has become a hot topic among China's neuroimaging researchers.

Gender influence on schizophrenia-relevant abnormalities in a cuprizone demyelination model

The aim of this study was to determine whether early demyelination can impact behavior in young adulthood. For this purpose, albino Wistar rats of either sex were exposed to cuprizone (CPZ) in two different intoxication protocols: one group was intoxicated before weaning (CPZ-BW), from postnatal day 7 (P7) to P21, through maternal milk, whereas the other group was intoxicated after weaning (CPZ-AW), from P21 to P35. After treatment, rats were returned to a normal diet until P90 when behavioral studies were performed. Both treatments produced marked demyelination in the corpus callosum and retraction of cortical myelin fibers. The subsequent normal diet allowed for effective remyelination at P90. Interestingly, CPZ-AW correlated with significant behavioral and neurochemical changes in a gender-dependent manner. CPZ-AW treatment altered both the number of social activities and the latency to the first social interaction in males, while also highly compromising recognition-related activities. In addition, only P90 males treated AW showed a hyperdopaminergic striatum, confirmed by an increase in tyrosine hydroxylase expression and in dopamine levels. Our results suggest that the timing of demyelination significantly influences the development of altered behavior, particularly in adult males.

[Personalised medicine in psychiatry and psychotherapy. A review of the current state-of-the-art in the biomarker-based early recognition of psychoses]

The main goal of psychiatric high-risk research--the personalised early recognition and intervention of schizophrenic and affective psychoses--is one of the biggest challenges of current clinical psychiatry due to the immense socioeconomic burden of these disorders. In this regard, this review discusses the prospects and caveats of new clinical, neuropsychological, neurophysiological and imaging-based concepts aimed at optimising the current state-of-the-art of early recognition. Finally, multivariate modelling and machine learning methods are presented as a novel methodological framework facilitating the decoding of early psychosis into different intermediate phenotypes. In the future, these phenotypes could be employed for a more objective risk stratification that operates at the single-subject level. This could allow us to generate clinically applicable prognostic biomarkers for these disorders that would propel the individualised prevention of disease transition, chronification and psychopharmacological treatment resistance of psychotic disorders.

Neuroanatomical markers of genetic liability to psychosis and first episode psychosis: a voxelwise meta-analytical comparison

OBJECTIVES

To address at a meta-analytical level the neuroanatomical markers of genetic liability to psychosis and a of first episode of psychosis.

METHODS

Fifteen voxel-based morphometry (VBM) studies of antipsychotic-naive subjects at genetic high-risk (HR) for psychosis or with a first-episode psychosis (FEP) were included in a Signed Differential Mapping (SDM) meta-analysis. Publication bias was assessed with funnel plots and Egger's intercept. Heterogeneity was assessed with Q statistics and I (2) index.

RESULTS

The database comprised 458 HR and 206 antipsychotic-naïve FEP subjects, matched with controls. Gray matter (GM) reductions as compared to controls, were observed in the left parahippocampal gyrus and in the bilateral anterior cingulate gyrus in the HR group, and in the right superior temporal gyrus, in the left insula and in the left cerebellum in the FEP group. Further GM decreases were observed in the FEP group as compared to the HR group in the left anterior cingulate, in the right precuneus, in the left cerebellum and in the right superior temporal gyrus. Limitations. The cross-sectional nature of the included studies prevented the comparison of high risk subjects who later did or did not develop a psychotic episode. Other caveats are based on the methodological heterogeneity across individual imaging studies.

CONCLUSIONS

GM reductions in the anterior cingulate are markers of genetic liability to psychosis while reductions in the superior temporal gyrus and cerebellum can be interpreted as markers of a first onset of the illness.

Multimodal voxel-based meta-analysis of structural and functional magnetic resonance imaging studies in those at elevated genetic risk of developing schizophrenia

Computational brain-imaging studies of individuals at familial high risk for psychosis have provided interesting results, but interpreting these findings can be a challenge due to a number of factors. We searched the literature for studies reporting whole brain voxel-based morphometry (VBM) or functional magnetic resonance imaging (fMRI) findings in people at familial high risk for schizophrenia compared with a control group. A voxel-wise meta-analysis with the effect-size version of Signed Differential Mapping (ES-SDM) identified regional abnormalities of functional brain response. Similarly, an ES-SDM meta-analysis was conducted on VBM studies. A multi-modal imaging meta-analysis was used to highlight brain regions with both structural and functional abnormalities. Nineteen studies met the inclusion criteria, in which a total of 815 familial high-risk individuals were compared to 685 controls. Our fMRI results revealed a number of regions of altered activation. VBM findings demonstrated both increases and decreases in grey matter density of relatives in a variety of brain regions. The multimodal analysis revealed relatives had decreased grey matter with hyper-activation in the left inferior frontal gyrus/amygdala, and decreased grey matter with hypo-activation in the thalamus. We found several regions of altered activation or structure in familial high-risk individuals. Reliable fMRI findings in the right posterior superior temporal gyrus further confirm that alteration in this area is a potential marker of risk.

Similar and different gray matter deficits in schizophrenia patients and their unaffected biological relatives

Neuroimaging studies have revealed significant reductions in the gray matter (GM) of several brain regions in patients with schizophrenia, a neuropsychiatric disorder with high hereditability. However, it is unclear whether unaffected relatives have GM abnormalities in common with their affected relatives, which may relate to susceptibility to developing schizophrenia. To address this issue, we conducted two separate meta-analyses of voxel-based morphometry to investigate GM abnormalities in schizophrenia patients and their unaffected relatives. One meta-analysis compared a patient group with healthy controls, whereas the other meta-analysis compared the unaffected relatives with healthy controls. Eight studies comprising 495 patients with schizophrenia, 584 unaffected relatives of patients, and 596 healthy controls were systematically included in the present study. Compared to healthy controls, the patient group showed decreased GM in the right cuneus, the right superior frontal gyrus, the right insula and the left claustrum, and increased GM in the bilateral putamen, the right parahippocampal gyrus, the left precentral gyrus, the left inferior temporal gyri, and the right cerebellar tonsil. The comparison between unaffected relatives and healthy controls showed a GM reduction in the left claustrum, the bilateral parahippocampal gyri, the left fusiform gyrus, the right inferior temporal gyrus, and the bilateral medial prefrontal cortices, whereas increased GM was observed in the right hippocampus, the right fusiform gyrus, the right precentral gyrus, and the right precuneus. Thus, our meta-analyses show that the GM changes in schizophrenia patients and their unaffected relatives are largely different, although there is subtle overlap in some regions.

Neuroanatomical deficits in drug-naïve adult patients with generalized social anxiety disorder: a voxel-based morphometry study

Little is known, so far, about the cerebral structural deficits in drug-naïve adult social anxiety disorder (SAD) patients. The present study aimed to explore the cerebral anatomic deficits in drug-naïve adult generalized SAD patients using voxel-based morphometric analysis with DARTEL. High-resolution T1-weighted images were acquired from 20 drug-naïve adult SAD patients and 19 age-, sex- and education-matched controls. The volumes of gray matter, white matter, cerebrospinal fluid, and total intracranial volume were compared between groups using two-sample t-tests with age and gender as covariates. Gray matter density (GMD) was compared between groups using voxel-wise two-sample t-test analysis. Correlation analysis was used to identify any associations between regional GMD and clinical symptoms. Compared with healthy controls, SAD patients showed significantly lower GMD in the bilateral thalami, right amygdala, and right precuneus. Furthermore, the GMD in the right amygdala was negatively related to the disease duration, but positively correlated with age of onset. Our findings demonstrated that cerebral anatomic deficits could be found within limbic and thalamic areas in drug-naïve SAD patients, which provides structural information to complement the functional alterations observed in the same regions.

White matter deficits in first episode schizophrenia: an activation likelihood estimation meta-analysis

BACKGROUND

Diffusion tensor imaging (DTI) has been widely used in psychiatric research and has provided evidence of white matter abnormalities in first episode schizophrenia (FES). The goal of the present meta-analysis was to identify white matter deficits by DTI in FES.

METHODS

A systematic search was conducted to collect DTI studies with voxel-wised analysis of the fractional anisotropy (FA) in FES. The coordinates of regions with FA changes were meta-analyzed using the activation likelihood estimation (ALE) method which weighs each study on the basis of its sample size.

RESULTS

A total of 8 primary studies were selected, including 271 FES patients and 297 healthy controls. Among these studies, 52 regions showed reductions in the FA in FES while 2 regions had increased FA. Consistent FA reductions in the white matter of the right deep frontal and left deep temporal lobes were identified in all FES patients relative to healthy controls. Fiber tracking showed that the main tracts involved were the cingulum bundle, the left inferior longitudinal fasciculus, the left inferior fronto-occipital fasciculus and the interhemispheric fibers running through the corpus callosum.

CONCLUSIONS

The current findings provide evidence confirming the lack of connection in the fronto-limbic circuitry at the early stages of the schizophrenia. Because the coordinates reported in the primary literature were highly variable, future investigations with large samples would be required to support the identified white matter changes in FES.

Brain metabolite alterations in young adults at familial high risk for schizophrenia using proton magnetic resonance spectroscopy

BACKGROUND

Proton magnetic resonance spectroscopy ((1)H MRS) enables in-vivo measurement of several relevant brain metabolites and has provided evidence of a range of neurochemical abnormalities in schizophrenia, especially in glutamate and N-acetyl-aspartate (NAA). While individuals at high familial risk for schizophrenia (HR) exhibit some neurobiological findings observed in the disorder, (1)H MRS findings and their clinical correlates are not well characterized in this population.

METHODS

We compared 23 adolescent and young adult offspring of schizophrenia patients with 24 age- and sex-matched healthy controls using (1)H MRS. We acquired multi-voxel, short TE (1)H MRS measurements at 1.5T and obtained metabolite concentrations of N-acetyl-aspartate (NAA), combined glutamate and glutamine (Glu+Gln) and choline-containing compounds (GPC+PC) for the left and right thalamus, anterior cingulate gyrus, and caudate. We also assessed the relationship between regional metabolite levels, clinical measures and brain volume in a subset of 16 high-risk and 15 control subjects.

RESULTS

Compared to healthy controls, high-risk subjects showed reductions in NAA levels in all three regions (thalamus, caudate, and anterior cingulate cortex), increases in Glu+Gln in the thalamus and caudate, and increases in GPC+PC in the anterior cingulate. In HR, thalamic Glu+Gln concentration was positively correlated and thalamic NAA inversely correlated with measures of schizotypy. Anterior cingulate GPC+PC and caudate Glu+Gln were significantly correlated with attenuated psychotic symptom severity. Anterior cingulate NAA was correlated with executive function.

CONCLUSIONS

Our data suggest the occurrence of metabolic alterations in young relatives of schizophrenia patients similar to those seen in patients with established illness. The observed correlations with cognitive deficits and psychosis-related psychopathology suggest that these metabolic measures may have value as biomarkers of risk for schizophrenia.

The neuroanatomy of psychotic diathesis: a meta-analytic review

BACKGROUND

Several studies have found widespread structural changes affecting the grey matter at various stages of schizophrenia (the prodrome, first-episode, and the chronic stage). It is unclear which of these neuroanatomical changes are associated with a predisposition or vulnerability to develop schizophrenia rather than the appearance of the clinical features of the illness.

METHODS

16 voxel-based morphometry (VBM) analyses involving 733 genetically high-risk relatives (HRR) of patients with schizophrenia, 563 healthy controls and 474 patients were meta-analysed using the Signed Differential Mapping (SDM) technique. Two meta-analyses were conducted, with one comparing HRR group with healthy controls and the other comparing HRR group with the patients.

RESULTS

A significant grey matter reduction in the lentiform nucleus, amygdala/parahippocampal gyrus and medial prefrontal cortex was seen in association with the genetic diathesis. Grey matter reduction in bilateral insula, inferior frontal gyrus, superior temporal gyrus and the anterior cingulate was seen in association with the disease expression.

CONCLUSIONS

The neuroanatomical changes associated with the genetic diathesis to develop schizophrenia appear to be different from those that contribute to the clinical expression of the illness. Grey matter abnormalities in multimodal brain regions that have a supervisory function are likely to be central to the expression of the clinical symptoms of schizophrenia.

Anatomical and functional deficits in patients with amnestic mild cognitive impairment

BACKGROUND

Anatomical and functional deficits have been studied in patients with amnestic mild cognitive impairment (MCI). However, it is unclear whether and how the anatomical deficits are related to the functional alterations. Present study aims to characterize the association between anatomical and functional deficits in MCI patients.

METHODS

Seventeen amnestic MCI patients and 18 healthy aging controls were scanned using a T1 Weighted MPRAGE sequence and a gradient-echo echo-planar imaging sequence. Clinical severity of MCI patients was evaluated by using Clinical Dementia Rating, Mini Mental State Examination (MMSE), Clock Drawing Test, Auditory Verbal Learning Test and Activities of Daily Living. VBM with DARTEL was used to characterize the gray matter deficits in MCI. Regional amplitude of low-frequency (0.01-0.08 Hz) fluctuations (ALFF) was used to evaluate regional functional alteration in MCI and fractional ALFF(fALFF) in slow 4 (0.027-0.073 Hz) and slow 5 (0.01-0.027 Hz) were also calculated.

RESULTS

Significantly decreased gray matter volume (GMV) was observed in amnestic MCI group mainly in bilateral prefrontal, left temporal and posterior cingulate cortex. Significant positive correlation was observed between the GMV in left inferior frontal gyrus and MMSE scores. Interestingly, decreased ALFF/fALFF was revealed in MCI group compared to controls mainly in prefrontal, left parietal regions and right fusiform gyrus, while the increased ALFF/fALFF was found in limbic and midbrain. Furthermore, the changes of fALFF in MCI in the slow-5 band were greater than those in the slow-4. No significant correlation was found between the morphometric and functional results.

CONCLUSIONS

Findings from the study document that wide spread brain volume reduction accompanied with decreased and increased regional function in MCI, while the anatomical and functional changes were independently. Therefore, the combination of structural and functional MRI methods would provide complementary information and together advance our understanding of the pathophysiology underlying the symptoms of MCI.

Convergent evidence from multimodal imaging reveals amygdala abnormalities in schizophrenic patients and their first-degree relatives

BACKGROUND

Shared neuropathological features between schizophrenic patients and their first-degree relatives have potential as indicators of genetic vulnerability to schizophrenia. We sought to explore genetic influences on brain morphology and function in schizophrenic patients and their relatives.

METHODS

Using a multimodal imaging strategy, we studied 33 schizophrenic patients, 55 of their unaffected parents, 30 healthy controls for patients, and 29 healthy controls for parents with voxel-based morphometry of structural MRI scans and functional connectivity analysis of resting-state functional MRI data.

RESULTS

Schizophrenic patients showed widespread gray matter reductions in the bilateral frontal cortices, bilateral insulae, bilateral occipital cortices, left amygdala and right thalamus, whereas their parents showed more localized reductions in the left amygdala, left thalamus and right orbitofrontal cortex. Patients and their parents shared gray matter loss in the left amygdala. Further investigation of the resting-state functional connectivity of the amygdala in the patients showed abnormal functional connectivity with the bilateral orbitofrontal cortices, bilateral precunei, bilateral dorsolateral frontal cortices and right insula. Their parents showed slightly less, but similar changes in the pattern in the amygdala connectivity. Co-occurrences of abnormal connectivity of the left amygdala with the left orbitofrontal cortex, right dorsolateral frontal cortex and right precuneus were observed in schizophrenic patients and their parents.

CONCLUSIONS

Our findings suggest a potential genetic influence on structural and functional abnormalities of the amygdala in schizophrenia. Such information could help future efforts to identify the endophenotypes that characterize the complex disorder of schizophrenia.

Putative structural neuroimaging endophenotypes in schizophrenia: a comprehensive review of the current evidence

The genetic contribution to schizophrenia etiopathogenesis is underscored by the fact that the best predictor of developing schizophrenia is having an affected first-degree relative, which increases lifetime risk by tenfold, as well as the observation that when both parents are affected, the risk of schizophrenia increases to approximately 50%, compared with 1% in the general population. The search to elucidate the complex genetic architecture of schizophrenia has employed various approaches, including twin and family studies to examine co-aggregation of brain abnormalities, studies on genetic linkage and studies using genome-wide association to identify genetic variations associated with schizophrenia. ‘Endophenotypes’, or ‘intermediate phenotypes’, are potentially narrower constructs of genetic risk. Hypothetically, they are intermediate in the pathway between genetic variation and clinical phenotypes and can supposedly be implemented to assist in the identification of genetic diathesis for schizophrenia and, possibly, in redefining clinical phenomenology.

Are we studying and treating schizophrenia correctly?

New findings are rapidly revealing an increasingly detailed image of neural- and molecular-level dysfunction in schizophrenia, distributed throughout interconnected cortico-striato-pallido-thalamic circuitry. Some disturbances appear to reflect failures of early brain maturation, that become codified into dysfunctional circuit properties, resulting in a substantial loss of, or failure to develop, both cells and/or appropriate connectivity across widely dispersed brain regions. These circuit disturbances are variable across individuals with schizophrenia, perhaps reflecting the interaction of multiple different risk genes and epigenetic events. Given these complex and variable hard-wired circuit disturbances, it is worth considering how new and emerging findings can be integrated into actionable treatment models. This paper suggests that future efforts towards developing more effective therapeutic approaches for the schizophrenias should diverge from prevailing models in genetics and molecular neuroscience, and focus instead on a more practical three-part treatment strategy: 1) systematic rehabilitative psychotherapies designed to engage healthy neural systems to compensate for and replace dysfunctional higher circuit elements, used in concert with 2) medications that specifically target cognitive mechanisms engaged by these rehabilitative psychotherapies, and 3) antipsychotic medications that target nodal or convergent circuit points within the limbic-motor interface, to constrain the scope and severity of psychotic exacerbations and thereby facilitate engagement in cognitive rehabilitation. The use of targeted cognitive rehabilitative psychotherapy plus synergistic medication has both common sense and time-tested efficacy with numerous other neuropsychiatric disorders.

Brain anatomical abnormalities in high-risk individuals, first-episode, and chronic schizophrenia: an activation likelihood estimation meta-analysis of illness progression

OBJECTIVE

The present study reviewed voxel-based morphometry (VBM) studies on high-risk individuals with schizophrenia, patients experiencing their first-episode schizophrenia (FES), and those with chronic schizophrenia. We predicted that gray matter abnormalities would show progressive changes, with most extensive abnormalities in the chronic group relative to FES and least in the high-risk group.

METHOD

Forty-one VBM studies were reviewed. Eight high-risk studies, 14 FES studies, and 19 chronic studies were analyzed using anatomical likelihood estimation meta-analysis.

RESULTS

Less gray matter in the high-risk group relative to controls was observed in anterior cingulate regions, left amygdala, and right insula. Lower gray matter volumes in FES compared with controls were also found in the anterior cingulate and right insula but not the amygdala. Lower gray matter volumes in the chronic group were most extensive, incorporating similar regions to those found in FES and high-risk groups but extending to superior temporal gyri, thalamus, posterior cingulate, and parahippocampal gryus. Subtraction analysis revealed less frontotemporal, striatal, and cerebellar gray matter in FES than the high-risk group; the high-risk group had less gray matter in left subcallosal gyrus, left amygdala, and left inferior frontal gyrus compared with FES. Subtraction analysis confirmed lower gray matter volumes through ventral-dorsal anterior cingulate, right insula, left amygdala and thalamus in chronic schizophrenia relative to FES.

CONCLUSIONS

Frontotemporal brain structural abnormalities are evident in nonpsychotic individuals at high risk of developing schizophrenia. The present meta-analysis indicates that these gray matter abnormalities become more extensive through first-episode and chronic illness. Thus, schizophrenia appears to be a progressive cortico-striato-thalamic loop disorder.

Are Bipolar Disorder and Schizophrenia Neuroanatomically Distinct? An Anatomical Likelihood Meta-analysis

Objective: There is renewed debate on whether modern diagnostic classification should adopt a dichotomous or dimensional approach to schizophrenia and bipolar disorder. This study synthesizes data from voxel-based studies of schizophrenia and bipolar disorder to estimate the extent to which these conditions have a common neuroanatomical phenotype. Methods: A post-hoc meta-analytic estimation of the extent to which bipolar disorder, schizophrenia, or both conditions contribute to brain gray matter differences compared to controls was achieved using a novel application of the conventional anatomical likelihood estimation (ALE) method. 19 schizophrenia studies (651 patients and 693 controls) were matched as closely as possible to 19 bipolar studies (540 patients and 745 controls). Result: Substantial overlaps in the regions affected by schizophrenia and bipolar disorder included regions in prefrontal cortex, thalamus, left caudate, left medial temporal lobe, and right insula. Bipolar disorder and schizophrenia jointly contributed to clusters in the right hemisphere, but schizophrenia was almost exclusively associated with additional gray matter deficits (left insula and amygdala) in the left hemisphere. Limitation: The current meta-analytic method has a number of constraints. Importantly, only studies identifying differences between controls and patient groups could be included in this analysis. Conclusion: Bipolar disorder shares many of the same brain regions as schizophrenia. However, relative to neurotypical controls, lower gray matter volume in schizophrenia is more extensive and includes the amygdala. This fresh application of ALE accommodates multiple studies in a relatively unbiased comparison. Common biological mechanisms may explain the neuroanatomical overlap between these major disorders, but explaining why brain differences are more extensive in schizophrenia remains challenging.

Regional gray matter volume in monozygotic twins concordant and discordant for schizophrenia

BACKGROUND

Alterations in gray matter volume (GMV) are a robust feature of schizophrenia. However, it is not clear to what extent these abnormalities are correlates of the genetic liability to the disorder, as opposed to environmental factors and the disorder itself. We investigated the influence of genetic and environmental risk on GMV in monozygotic (MZ) twin pairs concordant and discordant for schizophrenia.

METHODS

Total and regional GMVs were measured from magnetic resonance images of 80 twins: 14 MZ pairs concordant for schizophrenia, 9 pairs discordant for schizophrenia, and 17 healthy MZ twin pairs.

RESULTS

Total GMV was smaller in twins with schizophrenia (t = -3.17, p = .003) and nonpsychotic cotwins from discordant pairs (t = -2.66, p = .011) than in healthy control twins. Twin pairs concordant for schizophrenia displayed reduced regional GMV in the inferior frontal, medial frontal, and anterior cingulate gyri; the caudate; lingual gyrus; and cerebellum relative to healthy twins (p < .05, corrected). Within discordant pairs, twins with schizophrenia had less GMV than their nonpsychotic cotwins in the insula; superior/medial frontal, pre/postcentral, cingulate, and superior temporal gyri; and the paracentral lobule. There were no significant differences in regional GMV between nonpsychotic cotwins and healthy control subjects.

CONCLUSIONS

The presence of schizophrenia was specifically related to reduced GMV in frontal, insular, cingulate, medial parietal, and temporal cortex, over and above effects of genetic risk for the disorder. These changes could be related to the pathophysiology of the disorder itself or to unique environmental factors acting etiologically or because of the illness.

Anatomy of bipolar disorder and schizophrenia: a meta-analysis

BACKGROUND

Recent genetic results have indicated that the two major, classically distinct forms of psychosis - schizophrenia and bipolar disorder - may share causative factors in common. However it is not clear to what extent they may also have similar profiles of brain abnormality. We used meta-analytic techniques to generate and compare maps of brain structural abnormality in the large samples of patients with both disorders that have been studied using magnetic resonance imaging.

METHOD

A systematic search was conducted for voxel-based morphometry studies examining gray matter in patients with schizophrenia or bipolar disorder. The anatomical distribution of the co-ordinates of gray matter differences was meta-analysed using Anatomical Likelihood Estimation.

RESULTS

Forty-two schizophrenia studies including 2058 patients with schizophrenia and 2131 comparison subjects were compared with fourteen bipolar studies including 366 patients with bipolar disorder and 497 comparison subjects. In schizophrenia, there were extensive gray matter deficits in frontal, temporal, cingulate and insular cortex and thalamus, and increased gray matter in the basal ganglia. In bipolar disorder, gray matter reductions were present in the anterior cingulate and bilateral insula. These substantially overlapped with areas of gray matter reduction in schizophrenia, except for a region of anterior cingulate where gray matter reduction was specific to bipolar disorder.

IMPLICATIONS

In bipolar disorder studies there were consistent regional gray matter reductions in paralimbic regions (anterior cingulate and insula) implicated in emotional processing. Gray matter reductions in schizophrenia studies were more extensive and involved limbic and neocortical structures as well as the paralimbic regions affected in bipolar disorder.

Neuroimaging predictors of transition to psychosis--a systematic review and meta-analysis

OBJECTIVES

In early stage psychosis research the identification of neurobiological correlates of vulnerability to schizophrenia is an important hurdle.

METHODS

We systematically reviewed the neuroimaging publications on high-risk subjects with subsequent transition to psychosis (HR-T) and conducted a meta-analysis calculating the effect size Cohen's d.

RESULTS

Out of 30 identified studies 25 met the inclusion criteria. Structural (s)MRI studies showed small to medium effect sizes of decreased prefrontal, cingulate, insular and cerebellar gray matter volume in HR-T compared to high-risk subjects without transition (HR-NT). Meta-analysis revealed relatively larger whole brain volumes in HR-T compared to HR-NT subjects (mean Cohen's d 0.36, 95% CI 0.27-0. 46). Compared to HR-NT, HR-T subjects showed in functional imaging studies reduced brain activation in prefrontal cortex, reduced neuronal density, and increased membrane turnover in frontal and cingulate cortex with medium to large effect sizes.

CONCLUSIONS

Despite methodological differences between studies, structural and neurochemical abnormalities in prefrontal, anterior cingulate, medial temporal and cerebellar cortex might be predictive for development of psychosis within HR subjects.

Neurological disorders in schizophrenia

Schizophrenia (SZ) is a complex, heterogeneous, and disabling psychiatric disorder that impairs multiple aspects of human cognitive, perceptual, emotional, and behavioral functioning. SZ is relatively frequent (prevalence around 1%), with onset usually during adolescence or early adulthood, and has a deteriorating course. The rapidly growing area of neuroimaging research has has found clear evidence of many cortical and subcortical abnormalities in individuals with SZ. In this article the most recent findings from multiple studies on neurological disorders in SZ are reviewed, and the authors make a strong argument for a neurological basis of the schizophrenic process.

Computational morphometry for detecting changes in brain structure due to development, aging, learning, disease and evolution

The brain, like any living tissue, is constantly changing in response to genetic and environmental cues and their interaction, leading to changes in brain function and structure, many of which are now in reach of neuroimaging techniques. Computational morphometry on the basis of Magnetic Resonance (MR) images has become the method of choice for studying macroscopic changes of brain structure across time scales. Thanks to computational advances and sophisticated study designs, both the minimal extent of change necessary for detection and, consequently, the minimal periods over which such changes can be detected have been reduced considerably during the last few years. On the other hand, the growing availability of MR images of more and more diverse brain populations also allows more detailed inferences about brain changes that occur over larger time scales, way beyond the duration of an average research project. On this basis, a whole range of issues concerning the structures and functions of the brain are now becoming addressable, thereby providing ample challenges and opportunities for further contributions from neuroinformatics to our understanding of the brain and how it changes over a lifetime and in the course of evolution.

Neuroanatomical asymmetry patterns in individuals with schizophrenia and their non-psychotic siblings

Neuroanatomical endophenotypes may reveal insights into the processes by which genetic factors increase the risk of developing schizophrenia. To determine whether patterns of neuroanatomical asymmetries may be useful as schizophrenia-related endophenotypes, we compared patterns of structural asymmetries in patients with schizophrenia, healthy controls, and their respective siblings. The surfaces of the left and right amygdala, hippocampus, thalamus, caudate nucleus, putamen, globus pallidus, and nucleus accumbens were assessed in 40 pairs of healthy comparison controls (CON) and their siblings (CON-SIB) and 25 pairs of patients with schizophrenia (SCZ) and their siblings (SCZ-SIB) in magnetic resonance (MR) images using large deformation diffeomorphic metric mapping (LDDMM) and parallel transport techniques. The within-subject asymmetry deformation of each structure was first measured via LDDMM, and then translated to a global template via parallel transport for evaluation of the patterns of asymmetry both within and across siblings. Our results revealed that asymmetries observed in CON subjects occurred in the amygdala and the anterior segment of the hippocampus with more pronounced expansion deformation in the right-sided structures (R>L asymmetry) but not in the basal ganglia and thalamus. Disturbance in this pattern of asymmetries was observed in both SCZ and SCZ-SIB subjects. More specifically, exaggerations and reductions in the normative pattern of asymmetries were observed in the amygdala-hippocampus formation, basal ganglia, and thalamus. These altered patterns of asymmetries are present in subjects with schizophrenia and their siblings, and therefore may represent a schizophrenia-related endophenotype.