Shihabuddin L, Buchsbaum M S, Hazlett E A, Silverman J, New A, Brickman A M, Mitropoulou V, Nunn M, Fleischman M B, Tang C, Siever L J
Bronx Veterans Affairs Medical Center, Mental Health Patient Care Center, 130 W Kingsbridge Rd, Bronx, NY 10468, USA.
Arch Gen Psychiatry. 2001 Sep;58(9):877-84. doi: 10.1001/archpsyc.58.9.877.
Schizotypal personality disorder (SPD) shares social deficits and cognitive impairment with schizophrenia, but is not typically characterized by frank psychosis. Because striatal size and functional activity have both been shown to be associated with psychotic symptoms, we carried out the first study of SPD to assess the caudate and putamen for comparison with findings in schizophrenia.
Patients with SPD (n = 16), schizophrenic patients (n = 42), and age- and sex-matched normal control subjects (n = 47) were assessed with magnetic resonance imaging. All of the patients with SPD and subsamples of the schizophrenic patients (n = 27) and control subjects (n = 32) were also assessed with positron emission tomography using fluorodeoxyglucose F-18.
The relative size of the putamen in controls was significantly larger than in patients with SPD and significantly smaller than in schizophrenic patients, while the relative size of the caudate was similar in all 3 groups. Compared with control values, relative glucose metabolic rate in the ventral putamen was significantly elevated in patients with SPD and reduced in schizophrenic patients. When subsamples of schizophrenic patients (n = 10) and patients with SPD (n = 10) both of whom never received medication were compared, this pattern was more marked, with the highest value for the putamen being found in patients with SPD for the ventral slice and the lowest value for the right dorsal putamen.
Patients with SPD showed reduced volume and elevated relative glucose metabolic rate of the putamen compared with both schizophrenic patients and controls. These alterations in volume and activity may be related to the sparing of patients with SPD from frank psychosis.
分裂型人格障碍（SPD）与精神分裂症存在社交缺陷和认知障碍，但通常没有明显的精神病性症状。由于纹状体大小和功能活动均已显示与精神病性症状相关，我们开展了第一项关于SPD的研究，以评估尾状核和壳核，以便与精神分裂症的研究结果进行比较。
对16例SPD患者、42例精神分裂症患者以及年龄和性别匹配的47名正常对照者进行磁共振成像评估。所有SPD患者以及部分精神分裂症患者（27例）和对照者（32例）还使用氟脱氧葡萄糖F-18进行了正电子发射断层扫描评估。
对照组壳核的相对大小显著大于SPD患者，且显著小于精神分裂症患者，而三组尾状核的相对大小相似。与对照值相比，SPD患者腹侧壳核的相对葡萄糖代谢率显著升高，而精神分裂症患者则降低。当比较从未接受过药物治疗的精神分裂症患者亚组（10例）和SPD患者亚组（10例）时，这种模式更为明显，腹侧层面壳核的最高值出现在SPD患者中，右侧背侧壳核的最低值出现在精神分裂症患者中。
与精神分裂症患者和对照组相比，SPD患者壳核体积减小，相对葡萄糖代谢率升高。这些体积和活动的改变可能与SPD患者未出现明显精神病性症状有关。
