Cortical atrophy and white matter density in the brains of schizophrenics and clinical response to neuroleptics.

The relationship between clinical response to neuroleptics and brain morphology as revealed by CT scans was evaluated in a sample of 39 patients with schizophrenia and schizoaffective psychosis. Four measures of brain morphology previously shown to differ between schizophrenics and patients with headaches - white matter density, asymmetry in brain white matter density, sulcal width and global cortical atrophy - did not correlate with clinical improvement after 3 weeks treatment with constant doses of neuroleptics. These brain morphology measures also did not correlate with baseline psychopathology scores. The same results were found with scales or subscales reflecting primarily positive symptoms of schizophrenia as well as those reflecting primarily social withdrawal.