Pneumoencephalographic evidence of brain atrophy in acute and chronic schizophrenic patients.

Pneumoencephalography (PEG) was carried out in 50 patients of both sexes consecutively discharged from a psychiatric department with a diagnosis of acute schizophrenia. At clinical follow-up with a mean observation time of 8 years the diagnosis was verified in 38 patients, while 12 were considered to have had a reactive psychosis. The PEG findings and clinical findings in these two groups are compared, and compared to corresponding findings in 101 chronic schizophrenics previously studied with the same method. Linear measurements were used in estimating the size of the ventricular system, which was safely within normal limits in all but three of the 50 patients. Mean ventricular size did not differ significantly in the two groups of acute psychoses. No case of cortical atrophy was found. More than half of the chronic schizophrenics had abnormal PEG's, the typical finding being a bilateral enlargement of the ventricular system. The mean size of all parts of the ventricular system was significantly higher than in the acute schizophrenics. A close correlation was found between mental deterioration and ventricular enlargement. The most reasonable explanation of these findings is that schizophrenia is an inborn error of metabolism, disturbing normal brain function and in the long run leading to degenerative changes of the nervous tissue.