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Frontal and Caudate Alterations in Velocardiofacial Syndrome (Deletion at Chromosome 22q11.2)

Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, NY, Departments of Psychiatry and Behavioral Sciences, Johbns Hopkins University School of Medicine, Baltimore, MD

Courtney P. Burnette, MS

The Kennedy Krieger Institute, Baltimore, MD

Brandy A. Bessette, MA

Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, NY

Bradley S. Folley, MA

The Kennedy Krieger Institute, Baltimore, MD

Leslie Strunge, MA

The Kennedy Krieger Institute, Baltimore, MD

Ethylin W. Jabs, MD

Department of Pediatrics, Medicine and Plastic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD

Godfrey D. Pearlson, MD

Departments of Psychiatry and Behavioral Sciences, Johbns Hopkins University School of Medicine, Baltimore, MD, The Kennedy Krieger Institute, Baltimore, MD, The Institute of Living, Hartford, CT, Department of Psychiatry, Yale University, New Haven, CT

This study investigated the morphology of the frontal lobe and the caudate nucleus in velocardiofacial syndrome, a neurogenetic disorder caused by a microdeletion at chromosome 22q11.2 and frequently associated with severe psychiatric disturbances. Volumes of the caudate nucleus and subregions of the frontal lobe were compared on magnetic resonance images of 10 children with velocardiofacial syndrome and 10 age- and gender-matched controls. Frontal deep white matter was reduced significantly (by about 23%) in subjects with velocardiofacial syndrome relative to controls. Frontal and prefrontal volumes were also reduced in subjects with velocardiofacial syndrome, although not disproportionately to whole brain volume. The volume of the right caudate nucleus was increased in children with velocardiofacial syndrome. Associations between right caudate and right frontal regions were noted in controls but not in children with velocardiofacial syndrome. These findings suggest frontostriatal dysfunction in children with velocardiofacial syndrome. Insofar as up to 30% of adults with velocardiofacial syndrome (also known as chromosome 22q11 deletion syndrome) develop schizophrenia and frontostriatal dysfunction has been noted in schizophrenia, the findings support the hypothesis that velocardiofacial syndrome might represent a neurodevelopmental model of schizophrenia. (J Child Neurol 2004;19:337-342).

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