Dorsolateral prefrontal cortex volume in patients with deficit or nondeficit schizophrenia Umberto Volpe a, ⁎, Armida Mucci a , Mario Quarantelli b , Silvana Galderisi a , Mario Maj a a Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138 Naples, Italy b Biostructure and Bioimaging Institute, CNR and Diagnostic Imaging, University of Naples “Federico II”, Via Pansini, 5, 80131 Naples, Italy abstract article info Article history: Received 20 December 2011 Received in revised form 30 January 2012 Accepted 5 February 2012 Available online 10 February 2012 Keywords: Deficit schizophrenia Dorsolateral prefrontal cortex MRI Negative symptoms Deficit schizophrenia (DS) represents a promising putative clinical subtype of schizophrenia and is charac- terized by the presence of primary and enduring negative symptoms. Previous studies have often reported a reduced amount of gray matter within prefrontal and temporal cortices in schizophrenia subjects with prevailing negative symptoms; however, the evidence concerning brain structural abnormalities in patients with DS remains controversial. The aim of the present study was to investigate whether patients with DS differed from those with nondeficit schizophrenia (NDS) with respect to the volume of the dorsolateral prefrontal cortex (DLPFC) and hippocam- pus, two brain areas considered as key regions in the pathogenesis of schizophrenia. In the present study a 3D-T1w MR imaging procedure and an extensive clinical assessment was carried out in 18 patients with schizophrenia, (10 DS and 8 NDS). 3D MPRAGE images were preprocessed with SPM soft- ware and two regions of interest (hippocampus and DLPFC) were manually traced to obtain their gray matter volumes. We found a significant reduction of DLPFC in the entire schizophrenia group, with respect to healthy subjects. Although the subgroup of patients with DS had a more severe clinical picture and more impaired social func- tioning, the DLPFC volume reduction was greater in NDS than in DS patients. In conclusion, according to our structural neuroimaging findings, DS patients, although characterized by a more severe clinical picture and a worse outcome, show less neurobiological abnormalities. © 2012 Elsevier Inc. All rights reserved. 1. Introduction Current diagnostic criteria of schizophrenia have been widely crit- icized (Maj, 1998; Tandon et al., 2008). To solve the clinical puzzle of the heterogeneity of this complex syndrome, putative diagnostic sub- types have been proposed. Deficit schizophrenia (DS) is currently regarded as one of the most promising schizophrenia subtypes (Galderisi and Maj, 2009; Kirkpatrick and Galderisi, 2008). Although DS is a relatively rare clinical condition [its prevalence is less than 30% in clinical samples and below 20% in population studies; (Kirkpatrick et al., 2006)], it represents a stable clinical subtype of schizophrenia, characterized by the presence of primary and endur- ing negative symptoms (Carpenter et al., 1988), associated with a greater impairment of neurocognitive abilities (Buchanan et al., 1994; Cascella et al., 2008; Galderisi et al., 2002), social cognition (Cohen et al., 2007), and fronto-parietal functioning (Delamillieure et al., 2004), with a poorer response to treatment and with a worse outcome. Previous studies, investigating brain structural correlates of schizophrenia, have often reported an enlargement of brain lateral ventricles, an involvement of medial temporal structures (among those, especially hippocampus) and of frontal lobes (most notably prefrontal cortices) (for a recent review on the topic see, Shenton et al., 2010). However, previous evidence suggested that specific sub-regions of the frontal (namely, the dorsolateral prefrontal cortex or DLPFC) and temporal (in particular, the hippocampus) lobes might represent promising “candidate areas” to explain some key- aspects of the schizophrenia clinical picture (Meyer-Lindenberg et al., 2005). Previous studies (Besson et al., 1987; Chua et al., 1997; Ho et al., 2003; Mathalon et al., 2001; Pearlson et al., 1984; Roth et al., 2004; Williams et al., 1985) showed that schizophrenia patients with a high load of negative symptoms tend to have a reduced amount of gray matter within the prefrontal cortices, although the data remained controversial (Pfefferbaum and Zipursky, 1991; Wible et al., 2001, 1995; Williamson et al., 1991). Classical studies on hippocampus in schizophrenia have posited its involvement in spatial and episodic memory as well as in regulating affective states (Phillips et al., 2003), suggesting that volumetric changes of this brain region might be related to flat affect and anhe- donia; however, studies specifically dealing with this issue did not Progress in Neuro-Psychopharmacology & Biological Psychiatry 37 (2012) 264–269 ⁎ Corresponding author. Tel.: + 39 081 5666512; fax: + 39 081 5666523. E-mail address: umberto.volpe@unina2.it (U. Volpe). 0278-5846/$ – see front matter © 2012 Elsevier Inc. All rights reserved. doi:10.1016/j.pnpbp.2012.02.003 Contents lists available at SciVerse ScienceDirect Progress in Neuro-Psychopharmacology & Biological Psychiatry journal homepage: www.elsevier.com/locate/pnp