Suzuki Michio, Nohara Shigeru, Hagino Hirofumi, Kurokawa Kenzo, Yotsutsuji Takashi, Kawasaki Yasuhiro, Takahashi Tsutomu, Matsui Mie, Watanabe Naoto, Seto Hikaru, Kurachi Masayoshi
Department of Neuropsychiatry, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan.
Schizophr Res. 2002 May 1;55(1-2):41-54. doi: 10.1016/s0920-9964(01)00224-9.
This study examined regional structural changes in the whole brain in 45 medicated patients with schizophrenia (23 males and 22 females), comparing with 42 age- and sex-matched healthy volunteers (22 males and 20 females). Automated voxel-based analysis on three-dimensional magnetic resonance imaging (MRI) was conducted using statistical parametric mapping (SPM). Compared with the controls, relative gray matter in the patients was significantly reduced in the left superior temporal, left middle and inferior frontal, right inferior frontal, and bilateral anterior cingulate and medial temporal areas. Gray matter reductions in the left superior temporal and prefrontal areas were found predominantly in the male patients, while the anterior cingulate gray mater reduction was more striking in the female patients. On the contrary, significant gray matter increases in the patients were found in the parietal areas and the cerebellum. In the white matter, significant reduction was found in the bilateral anterior limbs of the internal capsule and the superior occipitofrontal fasciculus, whereas the bilateral parietal white matter showed significant increases. These results suggest that a pathological process in schizophrenia predominantly affects the fronto-temporolimbic-paralimbic regions. Reduced white matter in the connecting bundles, which was first found in this study, may imply morphological substrates for abnormalities in the fronto-thalamic and fronto-temporolimbic connectivity in schizophrenia.
本研究对45例接受药物治疗的精神分裂症患者（23例男性，22例女性）的全脑区域结构变化进行了检查，并与42名年龄和性别匹配的健康志愿者（22例男性，20例女性）进行了比较。使用统计参数映射（SPM）对三维磁共振成像（MRI）进行基于体素的自动分析。与对照组相比，患者左侧颞上回、左侧额中回和额下回、右侧额下回以及双侧前扣带回和内侧颞叶区域的相对灰质显著减少。左侧颞上回和前额叶区域的灰质减少主要见于男性患者，而前扣带回灰质减少在女性患者中更为明显。相反，患者顶叶区域和小脑的灰质显著增加。在白质方面，双侧内囊前肢和枕额上束出现显著减少，而双侧顶叶白质则显著增加。这些结果表明，精神分裂症的病理过程主要影响额颞叶边缘-旁边缘区域。本研究首次发现的连接束白质减少可能意味着精神分裂症中额丘脑和额颞叶边缘连接异常的形态学基础。
