Superior temporal gyrus volume change in schizophrenia: A review on Region of Interest volumetric studies

Imaging studies of schizophrenia (SCZ) have repeatedly demonstrated volume differences in superior temporal gyrus (STG) and its subregions. Among them, some studies employed the Region of Interest (ROI) method. We carried out a systematic review of the published literature on STG volumetry MRI studies to examine the potential of ROI method for identifying specific structural differences and correlations with clinical variables including hallucinations and thought disorder symptoms in SCZ. Forty-six studies were identified as suitable for review and analysis including 1444 patients with SCZ and 1327 controls. Female and left-handed subjects are under-represented in the literature and insight from sex and handedness differences may be lost. Thirty-five studies reported significant differences in STG or subregional volumes including bilateral or unilateral ROI, and volume reduction was the most common change in SCZ. Thirty studies reported correlations between volume changes and clinical symptoms or syndromes and 18 found positive results. Among them, left STG or subregions appear to be more involved in the generation of hallucinations and thought disorder than right side. The majority of five follow-up studies found evidence of progressive changes in volumes. Clinical heterogeneity, MRI acquisition parameters, anatomical landmarks for ROI, and sample characteristics, are likely to be the main factors leading to heterogeneous results. Clearly this research links pathophysiological changes in the STG with the development of hallucinations and thought disorder in patients with SCZ, especially in the left side. There is a suggestion that these changes may be progressive but this requires more thorough and comprehensive assessment.