Schizophrenia structural imaging — MRCPsych Paper A MCQ

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EasyNeuroimaging, neuroendocrinology and psychoneuroimmunologySchizophrenia structural imagingMRCPsych Paper A

A structural MRI study finds that, on average, adults with schizophrenia have larger lateral ventricles than age-matched healthy controls. Which is the best interpretation of this finding?

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Correct answer: E — A non-specific group-level structural brain difference associated with schizophrenia

Explanation lettering: D = shown as A · A = shown as B · B = shown as C · E = shown as D · C = shown as E

C is correct. Larger lateral ventricles are a replicated group-level structural imaging association in schizophrenia, including in first-episode samples, but the distributions overlap substantially with those of healthy people and other disorders. The finding therefore cannot confirm schizophrenia in an individual. The original neurodevelopmental wording was too categorical because ventricular and brain-volume differences may reflect heterogeneous developmental, illness-related and treatment-associated influences. Acute D2 receptor blockade is not a specific immediate cause of this cross-sectional finding, although treatment exposure may influence longitudinal brain-volume changes. A temporal lobe abscess produces a focal infective lesion rather than this group-level pattern. Ventricular enlargement also neither proves normality nor excludes psychiatric illness.

Reference: Fusar-Poli P, Meyer-Lindenberg A. Forty years of structural imaging in psychosis: promises and truth. Acta Psychiatrica Scandinavica. 2016. https://pubmed.ncbi.nlm.nih.gov/16738340/