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精神分裂症患者额叶和颞叶区域的体积测量:与阴性症状的关系。

Volumetric measure of the frontal and temporal lobe regions in schizophrenia: relationship to negative symptoms.

作者信息

Sanfilipo M, Lafargue T, Rusinek H, Arena L, Loneragan C, Lautin A, Feiner D, Rotrosen J, Wolkin A

机构信息

Psychiatry Service, New York Veterans Affairs Medical Center, New York, NY, USA.

出版信息

Arch Gen Psychiatry. 2000 May;57(5):471-80. doi: 10.1001/archpsyc.57.5.471.

Abstract

BACKGROUND

Previous research has provided evidence for brain abnormalities in schizophrenia, but their relationship to specific clinical symptoms and syndromes remains unclear.

METHODS

With an all-male demographically similar sample of 53 schizophrenic patients and 29 normal control subjects, cerebral gray and white matter volumes (adjusted for intracranial volume and age were determined for regions in the prefrontal lobe and in the superficial and mesial temporal lobe using T1-weighted magnetic resonance imaging with 2.8-mm coronal slices.

RESULTS

As a group, schizophrenic patients had wide-spread bilateral decrements in gray matter in the pre-frontal (7.4%) and temporal lobe regions (8.9%), but not in white matter in these regions. In the temporal lobe, gray matter reductions were found bilaterally in the superior temporal gyrus (6.0%), but not in the hippocampus and parahippocampus. While there were no overall group differences in white matter volumes, widespread decrements in prefrontal white matter in schizophrenic patients (n = 53) were related to higher levels of negative symptoms (partial r[49] = -0.42, P = .002), as measured by the Scale for the Assessment of Negative Symptoms. A post hoc analysis revealed that schizophrenic patients with high negative symptoms had generalized prefrontal white matter reductions (11.4%) that were most severe in the orbitofrontal subregion (15.1%).

CONCLUSIONS

These results suggest that gray matter deficits may be a fairly common structural abnormality of schizophrenia, whereas reductions in prefrontal white matter may be associated with schizophrenic negative symptoms.

摘要

背景

先前的研究已为精神分裂症患者大脑异常提供了证据,但其与特定临床症状及综合征之间的关系仍不明确。

方法

对53例精神分裂症男性患者和29名正常对照者组成的人口统计学特征相似的全男性样本,采用2.8毫米冠状面T1加权磁共振成像,测定额叶、颞叶浅层和内侧颞叶区域的脑灰质和白质体积(根据颅内体积和年龄进行校正)。

结果

作为一个群体,精神分裂症患者双侧额叶(7.4%)和颞叶区域(8.9%)的灰质广泛减少,但这些区域的白质未见减少。在颞叶,双侧颞上回灰质减少(6.0%),但海马体和海马旁回未见减少。虽然白质体积在总体上无组间差异,但精神分裂症患者(n = 53)额叶白质广泛减少与阴性症状水平较高有关(偏相关系数r[49] = -0.42,P = 0.002),阴性症状由阴性症状评定量表测量。事后分析显示,阴性症状高的精神分裂症患者额叶白质普遍减少(11.4%),在眶额亚区域最为严重(15.1%)。

结论

这些结果表明,灰质缺陷可能是精神分裂症相当常见的结构异常,而额叶白质减少可能与精神分裂症的阴性症状有关。

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