Högskolan i Skövde

Schizophrenia is a complex and often debilitating mental health disorder characterized by a constellation of symptoms that affect thinking, emotions, and behavior. The exploration of sex-specific differences in brain morphology has been and continues to be an area of ongoing interest, yet findings remain inconsistent. Significant gaps exist in understanding the various underlying factors, biological and psychological amongst others, and their impact on brain structure and symptom manifestation. This systematic review aims to address sex-specific differences in brain structure in individuals with schizophrenia and their potential associations with symptom manifestation. A total of six studies were included through Web of Science and PubMed. To assess schizophrenia symptoms, six rating scales were used and the majority of the studies used magnetic resonance imaging techniques (MRI), while two used diffusion imaging techniques (DTI). Findings suggest sex-specific structural differences within corpus callosum, cerebellum, Heschl’s gyrus, cerebellar vermis, hippocampal volume, and white matter (WM) in torque (asymmetry in brain shape and size). These structural differences may underlie the variation in symptom manifestation between males and females, where females showed fewer symptoms linked to reduced volumes in specific brain regions and males exhibited more severe symptoms correlating with greater hippocampal and brain volumes and varied cortical thickness. However, the wide range of observed structural differences presents challenges in drawing definitive conclusions. Further investigation into the underlying mechanisms driving these sex-specific differences is warranted.