White matter microstructure in schizophrenia patients with a history of violence

  • Natalia Tesli
  • Lars T. Westlye
  • Guttorm B. Storvestre
  • Tiril P. Gurholt
  • Ingrid Agartz
  • Ingrid Melle
  • Ole A. Andreassen
  • Unn K. HaukvikEmail author
Original Paper


Schizophrenia (SCZ) is associated with increased risk of violence compared to the general population. Neuroimaging research suggests SCZ to be a disorder of disrupted connectivity, with diffusion tensor imaging (DTI) indicating white matter (WM) abnormalities. It has been hypothesized that SCZ patients with a history of violence (SCZ-V) have brain abnormalities distinguishing them from SCZ patients with no history of violence (SCZ-NV). Yet, a thorough investigation of the neurobiological underpinnings of state and trait measures of violence and aggression in SCZ derived from DTI indices is lacking. Using tract-based spatial statistics, we compared DTI-derived microstructural indices: fractional anisotropy (FA), mean, axial (AD) and radial diffusivity across the brain; (1) between SCZ-V (history of murder, attempted murder, or severe assault towards other people, n = 24), SCZ-NV (n = 52) and healthy controls (HC, n = 94), and (2) associations with current aggression scores among both SCZ groups. Then, hypothesis-driven region of interest analyses of the uncinate fasciculus and clinical characteristics including medication use were performed. SCZ-V and SCZ-NV showed decreased FA and AD in widespread regions compared to HC. There were no significant differences on any DTI-based measures between SCZ-V and SCZ-NV, and no significant associations between state or trait measures of aggression and any of the DTI metrics in the ROI analyses. The DTI-derived WM differences between SCZ and HC are in line with previous findings, but the results do not support the hypothesis of specific brain WM microstructural correlates of violence or aggression in SCZ.


Diffusion tensor imaging Schizophrenia Violence Aggression Uncinate fasciculus 



This work was funded by the Research Council of Norway Grant #223273, the K.G. Jebsen Foundation, and the South Eastern Norway Health Authorities Grant #2016044.

Compliance with ethical standards 

Conflict of interest

All authors report no conflict of interests.

Ethical approval

All procedures were in accordance with the ethical standards of the institution, approved by the Norwegian regional comitte for ethics in medical research, and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Supplementary material

406_2019_988_MOESM1_ESM.docx (86 kb)
Supplementary material 1 (DOCX 85 KB)


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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical MedicineUniversity of OsloOsloNorway
  2. 2.NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and AddictionOslo University HospitalOsloNorway
  3. 3.Department of PsychologyUniversity of OsloOsloNorway
  4. 4.Department of PsychiatryOstfold Hospital TrustGraalumNorway
  5. 5.Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
  6. 6.Department of Adult Psychiatry, Institute of Clinical MedicineUniversity of OsloOsloNorway

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