Am J Psychiatry 1991; 148:1189-1194
Copyright © 1991 by American Psychiatric Association
Lateral ventricle-brain ratio and balance between CSF HVA and 5-HIAA in schizophrenia
RR Lewine, SC Risch, E Risby, M Stipetic, RD Jewart, M Eccard, J Caudle and W Pollard
Department of Psychiatry, Emory University School of Medicine, Atlanta, GA 30322.
OBJECTIVE: Lateral ventricle enlargement in schizophrenia has been
positively correlated with poor premorbid competence, negative symptoms,
and poor treatment response and negatively correlated with concentrations
of homovanillic acid (HVA), a dopaminergic metabolite. The authors provide
further evidence of a reciprocal relationship between lateral ventricle
size and dopaminergic activity in schizophrenia. METHOD: They assessed the
relationship between lateral ventricle enlargement (ventricle-brain ratio,
VBR) and CSF neurotransmitter metabolite concentrations (HVA and 5-
hydroxyindoleacetic acid [5-HIAA]) in 45 patients with schizophrenia, 28
with affective disorders (19 patients with major depression and nine with
bipolar disorder), and 91 normal comparison subjects. RESULTS: No group
mean differences were significant. Although individual correlations of VBR
with HVA and 5-HIAA were not statistically significant, the ratio of HVA to
5-HIAA was significantly correlated with VBR in the patients with
schizophrenia, a finding consistent with dopaminergic-serotonergic balance
hypotheses. CONCLUSIONS: These data suggest that it is the balance between
HVA and 5-HIAA rather than their absolute levels which is associated with
brain morphology and that this relationship between brain chemistry and
morphology may be characteristic of the normal range of functioning for
these systems. In other words, independent of whether brain morphology and
chemistry differentiate psychopathological from nonpsychopathological
states, there may be an orderly relationship between lateral ventricle size
and the balance between HVA and 5-HIAA balance that is especially prominent
in schizophrenia.
