Shapleske Jane, Rossell Susan L, Chitnis Xavier A, Suckling John, Simmons Andrew, Bullmore Edward T, Woodruff Peter W R, David Anthony S
Department of Psychological Medicine, Institute of Psychiatry, London SE5 8AF, UK.
Cereb Cortex. 2002 Dec;12(12):1331-41. doi: 10.1093/cercor/12.12.1331.
Quantitative magnetic resonance imaging (MRI) studies in patients with schizophrenia have shown reliable deficits in global tissue volume as well as some regionally specific changes, particularly in the temporal and frontal lobes. Recent technical advances have enabled automated voxel-wise analyses, which have the advantage of facilitating whole brain coverage without the restrictions of anatomically defined regions of interest and imperfect rater reliability. We used such a method to estimate voxel composition from segmentation of bivariate, dual-echo spin-echo data in 72 men with schizophrenia. Of these, 41 had a prominent history of auditory-verbal hallucinations and 31 had no such history. The patients were compared with 32 age, gender, handedness and IQ matched healthy controls. The study revealed localized areas of reduced grey-matter tissue proportion aggregating around the medial temporal lobes, the insulae, orbito-frontal cortex including anterior cingulate, and the precuneus (and lingual) gyri, in the schizophrenia patients as a whole. There were also reductions in white-matter tissue proportion extending along much of the large anterior-posterior frontal tracts in the right hemisphere. Small regions of increased grey matter were also noted in the right inferior parietal lobe. A contrast between the hallucinator and non-hallucinator patient groups showed a single region of reduced grey-matter tissue proportion affecting the left insula and adjacent temporal lobe. These data confirm the utility of voxel-based morphometric methods in schizophrenia research and point towards disruption to a 'paralimbic' neural network, as underlying schizophrenic psychopathology in general, with abnormalities of the left insula specifically related to hallucinations.
对精神分裂症患者进行的定量磁共振成像（MRI）研究表明，患者在全脑组织体积方面存在可靠的缺损，同时也有一些区域特异性变化，尤其是在颞叶和额叶。最近的技术进步使得自动体素分析成为可能，这种分析方法的优点是能够实现全脑覆盖，不受解剖学定义的感兴趣区域的限制，也不存在评分者可靠性不完善的问题。我们使用这种方法，通过对72名男性精神分裂症患者的双变量、双回波自旋回波数据进行分割来估计体素组成。其中，41人有明显的幻听病史，31人没有此类病史。将这些患者与32名年龄、性别、利手和智商相匹配的健康对照者进行比较。研究发现，总体而言，精神分裂症患者中灰质组织比例降低的局部区域集中在内侧颞叶、脑岛、包括前扣带回的眶额皮质以及楔前叶（和舌回）。右半球沿大部分额叶前后大神经束也存在白质组织比例降低的情况。在右侧顶下小叶还发现了小区域的灰质增加。幻觉患者组与非幻觉患者组之间的对比显示，有一个灰质组织比例降低的单一区域，影响左侧脑岛和相邻的颞叶。这些数据证实了基于体素的形态测量方法在精神分裂症研究中的实用性，并指出“边缘旁”神经网络的破坏是精神分裂症一般精神病理学的基础，其中左侧脑岛的异常与幻觉特别相关。
