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The Slyvian Fissures: Asymmetry, Morphology and Psychosis

The Slyvian Fissures: Asymmetry, Morphology and Psychosis

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An essay for the 2012 Undergraduate Awards (International Programme) Competition by Lewis Hou. Originally submitted for Neuroscience Project at University of Edinburgh, with lecturer Professor Richard Ribchester in the category of Medical Sciences
An essay for the 2012 Undergraduate Awards (International Programme) Competition by Lewis Hou. Originally submitted for Neuroscience Project at University of Edinburgh, with lecturer Professor Richard Ribchester in the category of Medical Sciences

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Published by: Undergraduate Awards on Aug 31, 2012
Copyright:Attribution Non-commercial

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03/24/2014

 
The Sylvian Fissures: Asymmetry, Morphology and Psychosis 
 
 T
HE
S
 YLVIAN
F
ISSURES
:
 
 A
SYMMETRY 
,
 
M
ORPHOLOGY AND
P
SYCHOSIS
 
7
 TH
 
M
 AY 
2012
 
The Sylvian Fissures: Asymmetry, Morphology and Psychosis 
 
 A 
BSTRACT
For over a century, it has been observed that the Sylvian Fissures (SF) typically have aleftward length bias, which is suggested to underlie functional lateralisation of languageand auditory processing. Studies have reported this structural asymmetry to be disturbedin patients with schizophrenia, although this is not uncontroversial, and the lack of consistent definitions of its variable anatomy, combined with crude measurementmethodologies, may have limited conclusive findings to date. This exploratory pilot study therefore integrated a classification from Witelson & Kigar(1992) dividing the SF into Anterior, Horizontal and Vertical aspects into MRI-analysissoftware BrainVISA to explore whether schizophrenic patients ( 
n =
16) demonstratedatypical lateralisation compared to matched controls ( 
= 16). 3-way MANOVA analysisfound a significant diagnosis-by-sex interaction (Pillai’s Trace (3, 48) = 3.022;
 p
= 0.039).
Horizontal SF: 
Post-hoc tests identified that male patients had a larger right segments thanmale controls ( 
(7) = -3.321;
 p
= 0.013), which reduced the leftward, though non-significant, asymmetry that male controls had. Female controls showed no asymmetricaltrend at all, which may indicate a sex difference in lateralisation patterns in both healthand illness. In contrast to previous findings, however, the
 Anterior 
or
Vertical SF 
lengthsdid not demonstrate any significant deviation from symmetry.Overall, our findings were consistent with reduced lateralisation in male schizophrenics,and as the differences were specific to only the Horizontal-SF aspects, highlight theimportance of demarcating the SF morphology consistently in future research, and alsosuggest the presence of sex differences that should be considered further in future. Although we must be cautious as the study lacked statistical power, we did successfully integrate a standard classification for the SF into the BrainVISA software that can be theplatform for more powerful studies into this in the future, which may eventually lead to abetter understanding of the structural correlates of schizophrenia, “the disease of humanity” (Crow, 1997: 130).
 
The Sylvian Fissures: Asymmetry, Morphology and Psychosis 
I
NTRODUCTION
 
3
I
NTRODUCTION
 
1.0
 
S
CHIZOPHRENIA
“The disease of humanity”, (Crow, 1997: 130 ),schizophrenia is a common, complex andmultilevel disorder that affects up to 1 in a 100 people (Jablensky, 1997; Glasel
et al 
.,2011). With heritability point estimates of up to 81% (Sullivan
et al 
., 2003), both geneticsand environment contribute to the disorder, which is characterised by subtle butpervasive alterations in structure and function, and neuroimaging has been increasingly applied to explore this. The literature is vast and, mirroring the disorder itself,fragmented, though recent trends in using larger datasets through databases andcollaboration, and increasing sophisticated designs mean that some findings are achieving a fair degree of consistency.1.1
 
 A
SYMMETRY 
One of the early structural observations made was the tendency for schizophrenicpatients to deviate from the typical global frontal right and occipital left “twist”(Yakovlevian Torque) of the brain (Pearlson, 1997; Mackay, 1998; Cachia
et al 
., 2008)(Figure 1). Local asymmetry changes were also found, primarily focused in thePerisylvian region of the brain: compared to the typical leftward bias of the Heschl’sGyrus (HG) (Shergill
et al 
., 2000; Dorsaint-Pierre, 2006) and the Planum Temporale (PT)(Shapleske
et al 
., 1999; Horn
et al 
., 2009), patients have demonstrated reducedasymmetries in both (Kwon
et al 
., 1999; Oertel
et al 
., 2010), although this has not beenconsistent (Barta
et al 
., 1997). Different definitions of the structures, and population agemay account for this: some groups have suggested that asymmetry perturbations may beprogressive rather than static (Toga and Thompson, 2003) and so cohort age, andduration of disorder may be critical.1.2
 
L
 ATERALITY 
 As the perisylvian regions are associated with both language and auditory processing,these structural asymmetries have been argued to underlie the functional lateralisation,i.e. different hemispheric specialisation, of these faculties (e.g. Toga and Thompson,2003). Whilst an oversimplified, binary understanding of lateralisation of function iscommonly popularised, there is an extensive literature to suggest that there are distinctoverarching principles, rather than functions
 per se 
, to the hemispheres (see McGilchrist,2009). In language, articulate and formal aspects such as grammar are represented in 90-96% right-handed population on the left (Pujol
et al 
., 2002), whilst global aspects of language such as prosody and humour are represented on the right (Mitchell and Crow,2005). This varies within the population, and handedness has been argued to be anindicator that is associated with language lateralisation (reviewed by Hatta, 2007) thoughthis is relative and not absolute: in sinistrals, articulate language is left-lateralised only 70% of the time. (Josse and Tzourio-Mazoyer, 2004)

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