Lawrie S M, Whalley H, Kestelman J N, Abukmeil S S, Byrne M, Hodges A, Rimmington J E, Best J J, Owens D G, Johnstone E C
Department of Psychiatry, Royal Edinburgh Hospital, UK.
Lancet. 1999 Jan 2;353(9146):30-3. doi: 10.1016/S0140-6736(98)06244-8.
Schizophrenia is a multifactorial disorder that is associated with disturbed cerebral development. Structural brain-imaging studies have consistently shown that the volumes of some parts of the brain, particularly the mesial temporal lobes, are smaller in patients with schizophrenia than in healthy people. Whether these abnormalities of brain structure predate the onset of symptoms is not known.
100 people at high risk of developing schizophrenia (two or more first-degree or second-degree relatives affected), 20 patients in their first episode of schizophrenia, and 30 healthy controls underwent magnetic resonance imaging of the brain. The volumes of regions of interest were measured by standard techniques.
Mean whole-brain volume was 1356 cm3 (SD 178) in the first-episode group, 1347 cm3 (122) in the high-risk group, and 1334 cm3 (149) in the controls (p=0.8). The mean volume of the left amygdala-hippocampal complex (AHC) was lower in the first-episode group (4.3 cm3 [0.6]) than in the high-risk group (4.6 cm3 [0.6]), and in turn than in the controls (4.8 cm3 [0.7]); these differences were significant (p<0.05) both for absolute volumes and values adjusted for brain volume and other confounders. The right AHC showed a similar pattern (absolute volumes 4.5 cm3 [0.7], 4.8 cm3 [0.6], 4.9 cm3 [0.9], respectively). Both thalamic nuclei were significantly smaller in the high-risk group than in the control group.
People at high risk of developing schizophrenia for genetic reasons have several structural brain abnormalities that are similar to those in patients with the disorder. If at-risk individuals with particularly small AHC or thalami are most likely to develop schizophrenia, this feature might assist in early detection and treatment.
精神分裂症是一种多因素疾病，与大脑发育紊乱有关。脑结构成像研究一直表明，精神分裂症患者大脑某些部位的体积，特别是内侧颞叶，比健康人小。这些脑结构异常是否早于症状出现尚不清楚。
100名有患精神分裂症高风险的人（有两个或更多一级或二级亲属患病）、20名首次发作的精神分裂症患者以及30名健康对照者接受了脑部磁共振成像检查。通过标准技术测量感兴趣区域的体积。
首次发作组的平均全脑体积为1356立方厘米（标准差178），高风险组为1347立方厘米（122），对照组为1334立方厘米（149）（p = 0.8）。首次发作组左侧杏仁核 - 海马复合体（AHC）的平均体积（4.3立方厘米[0.6]）低于高风险组（4.6立方厘米[0.6]），进而低于对照组（4.8立方厘米[0.7]）；这些差异在绝对体积以及根据脑体积和其他混杂因素调整后的值方面均具有统计学意义（p<0.05）。右侧AHC呈现类似模式（绝对体积分别为4.5立方厘米[0.7]、4.8立方厘米[0.6]、4.9立方厘米[0.9]）。高风险组的两个丘脑核均显著小于对照组。
因遗传因素有患精神分裂症高风险的人存在一些与该疾病患者相似的脑结构异常。如果AHC或丘脑特别小的高危个体最有可能患精神分裂症，这一特征可能有助于早期检测和治疗。
