IntroductionThe liability for schizophrenia is heritable, 1 with siblings of patients with schizophrenia being at increased risk (about a 10-fold increase) for the disorder.2 Structural brain abnormalities in patients with schizophrenia have been consistently reported. For example, patients show reduced grey matter in the frontal, temporal and thalamic regions (see the meta-analyses by Fornito and colleagues 3 and Haijma and colleagues 4 ). Previous studies have suggested that part of these grey matter abnormalities might not be related to the illness state, but rather to the genetic risk, and have proposed these abnormalities to be an endophenotype for schizophrenia. [5][6][7] Consistent with this proposal, 4 recent meta-analyses reported grey matter reductions in relatives of patients compared with controls. [8][9][10][11] Although the aims of these meta-analyses differed, all of them compared individuals at genetic high risk with controls. However, the results of these meta-analyses differed substantially, and the thresholds applied were rather low (p < 0.05, p < 0.005 and p < 0.001, uncorrected). Two meta-analyses showed grey matter reductions in relatives compared with controls in the lentiform nucleus 9,11 and medial prefrontal cortex, 9 whereas another meta-analysis reported higher levels of grey matter in the medial prefrontal cortex in siblings.11 Furthermore, reductions in the parahippompal gyrus and anterior cingulate have been reported, 8 while others reported reductions in the amygdala and hippocampus.10 Besides these contradictory reports, the 3 largest voxel-based morphometry (VBM) studies in siblings 12-14 did not report any significant differences in whole brain grey matter between siblings and controls.In a recent review, several hypotheses were proposed to explain these differences. 5 The first explanation was that many studies included participants who were already past the critical ages for schizophrenia developing. The onset of Background: Grey matter, both volume and concentration, has been proposed as an endophenotype for schizophrenia given a number of reports of grey matter abnormalities in relatives of patients with schizophrenia. However, previous studies on grey matter abnormalities in relatives have produced inconsistent results. The aim of the present study was to examine grey matter differences between controls and siblings of patients with schizophrenia and to examine whether the age, genetic loading or subclinical psychotic symptoms of selected individuals could explain the previously reported inconsistencies. Methods: We compared the grey matter volume and grey matter concentration of healthy siblings of patients with schizophrenia and healthy controls matched for age, sex and education using voxel-based morphometry (VBM). Furthermore, we selected subsamples based on age (< 30 yr), genetic loading and subclinical psychotic symptoms to examine whether this would lead to different results. Results: We included 89 siblings and 69 controls in our study. The results showed that sibl...