Wright I C, Rabe-Hesketh S, Woodruff P W, David A S, Murray R M, Bullmore E T
Department of Psychological Medicine, Institute of Psychiatry, University of Manchester, UK.
Am J Psychiatry. 2000 Jan;157(1):16-25. doi: 10.1176/ajp.157.1.16.
The authors' goal was to determine whether patients with schizophrenia differ from comparison subjects in regional brain volumes and whether these differences are similar in male and female subjects.
They conducted a systematic search for structural magnetic resonance imaging (MRI) studies of patients with schizophrenia that reported volume measurements of selected cortical, subcortical, and ventricular regions in relation to comparison groups. They carried out a meta-analysis of the volumes of these regions in the patients with schizophrenia and the comparison subjects using a random effects model; they also used random effects regression analysis to examine the influence of gender on effect sizes.
Fifty-eight studies were identified as suitable for analysis; these studies included 1,588 independent patients with schizophrenia. Assuming a volume of 100% in the comparison group, they found that the mean cerebral volume of the subjects with schizophrenia was smaller (98%), but the mean total ventricular volume of the subjects with schizophrenia was greater (126%). Relative to the cerebral volume differences, the regional volumes of the subjects with schizophrenia were 94% in the left and right amygdala, 94% in the left and 95% in the right hippocampus/amygdala, and 93% in the left and 95% in the right parahippocampus. Relative to the global ventricular system differences, the largest differences in ventricular subdivisions were in the right and left body of the lateral ventricle, where the volumes of schizophrenic subjects were 116% and 116%, respectively. For most regions, effect size was not significantly related to gender.
Regional structural differences in patients with schizophrenia include bilaterally reduced volume of medial temporal lobe structures. There is a need for greater integration of results from structural MRI studies to avoid redundant research activity.
作者的目标是确定精神分裂症患者在脑区体积上是否与对照受试者存在差异,以及这些差异在男性和女性受试者中是否相似。
他们系统检索了关于精神分裂症患者的结构磁共振成像(MRI)研究,这些研究报告了选定的皮质、皮质下和脑室区域相对于对照组的体积测量值。他们使用随机效应模型对精神分裂症患者和对照受试者这些区域的体积进行了荟萃分析;还使用随机效应回归分析来检验性别对效应大小的影响。
58项研究被确定适合分析;这些研究包括1588例独立的精神分裂症患者。假设对照组的体积为100%,他们发现精神分裂症患者的平均脑体积较小(98%),但精神分裂症患者的平均总脑室体积较大(126%)。相对于脑体积差异,精神分裂症患者左侧和右侧杏仁核的区域体积为94%,左侧海马体/杏仁核为94%,右侧为95%,左侧海马旁回为93%,右侧为95%。相对于全球脑室系统差异,脑室细分中最大的差异在侧脑室的左右体部,精神分裂症患者在这些部位的体积分别为116%和116%。对于大多数区域,效应大小与性别无显著相关性。
精神分裂症患者的区域结构差异包括双侧内侧颞叶结构体积减小。需要更好地整合结构MRI研究的结果,以避免重复的研究活动。