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Gyrification of the human cerebral cortex starts in the foetus and progresses in early infancy; the pattern of folding in later life provides a lead to early developmental aberration. By studying gyrification at illness onset in adolescence we hoped to clarify the pathophysiology of schizophrenia. Here we find 1) an area of hypergyria includes Broca's area and extends into the Sylvian fissure to encroach on the anterior insula in the left hemisphere, and 2) an area of hypogyria in the superior temporal lobe approximates to Wernicke's area but is located in the right hemisphere and encroaches on the posterior insula. In Broca's/anterior insula area, right lateralization was present in healthy controls but patients were left lateralized: at two year follow-up gyrification had decreased in patients while it increased in controls, and the reduction predicted impaired category fluency. Progressive change was unaccompanied by cortical thinning (investigated only in the brain regions showing baseline changes in gyrification) indicating that the disease process affecting these brain regions (insula, inferior frontal and superior temporal) is not primarily degenerative. A deviation in the lateralized development of peri-Sylvian areas for language production and comprehension appears critical to the pathophysiology of schizophrenia and may point to its species-specific origin.

Original publication

DOI

10.1016/j.schres.2013.03.028

Type

Journal article

Journal

Schizophr Res

Publication Date

06/2013

Volume

147

Pages

39 - 45

Keywords

Adolescent, Brain Mapping, Disease Progression, Female, Frontal Lobe, Functional Laterality, Humans, Imaging, Three-Dimensional, Linear Models, Longitudinal Studies, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Schizophrenia, Young Adult