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精神分裂症患者死后大脑额叶灰质体积较小。

Smaller frontal gray matter volume in postmortem schizophrenic brains.

作者信息

Selemon Lynn D, Kleinman Joel E, Herman Mary M, Goldman-Rakic Patricia S

机构信息

Department of Neurobiology, Yale University School of Medicine, PO Box 208001, New Haven, CT 06520-8001, USA.

出版信息

Am J Psychiatry. 2002 Dec;159(12):1983-91. doi: 10.1176/appi.ajp.159.12.1983.

Abstract

OBJECTIVE

The prefrontal cortex exhibits prominent functional, biochemical, and anatomic abnormalities in schizophrenic patients. However, smaller than normal volume of the frontal lobe has not been found in previous postmortem studies of schizophrenic subjects, and magnetic resonance imaging (MRI) scans of schizophrenic subjects have not consistently revealed frontal volumetric deficits. The variability in MRI findings may be related partly to difficulty in defining the posterior border of the frontal lobe. In this study, precise measurements of frontal lobe volume from postmortem brains were derived by defining the posterior border according to the brain atlas of Talairach and Tournoux and by applying stereologic methods to estimate gray and white matter volumes.

METHOD

Whole, or nearly whole, formalin-fixed left hemispheres from 14 schizophrenic and 19 normal comparison subjects were analyzed. Total cortical gray and white matter volumes, as well as frontal cortical gray and white matter volumes, were measured by using the Cavalieri method.

RESULTS

Only frontal gray matter volume was significantly smaller in the schizophrenic subjects than in the comparison subjects (12% difference). The differences between groups in total gray and white matter volumes and frontal white matter volume (6%-8% smaller in the schizophrenic subjects than in the comparison subjects) did not reach statistical significance.

CONCLUSIONS

The smaller frontal gray matter volume observed in schizophrenic brains suggests that pathology of the frontal lobe may be more severe than that of the three posterior lobes and may account for the prominence of prefrontal dysfunction associated with schizophrenia.

摘要

目的

前额叶皮质在精神分裂症患者中表现出显著的功能、生化和解剖学异常。然而,在先前对精神分裂症患者的尸检研究中未发现额叶体积小于正常,并且对精神分裂症患者的磁共振成像(MRI)扫描也未一致显示额叶体积缺损。MRI结果的变异性可能部分与难以界定额叶后边界有关。在本研究中,通过根据Talairach和Tournoux脑图谱界定后边界,并应用体视学方法估计灰质和白质体积,从尸检大脑中精确测量额叶体积。

方法

分析了14例精神分裂症患者和19例正常对照者完整的或几乎完整的福尔马林固定左半球。使用卡瓦列里方法测量总皮质灰质和白质体积以及额叶皮质灰质和白质体积。

结果

精神分裂症患者仅额叶灰质体积显著小于对照者(相差12%)。两组在总灰质和白质体积以及额叶白质体积方面的差异(精神分裂症患者比对照者小6%-8%)未达到统计学显著性。

结论

在精神分裂症患者大脑中观察到的较小额叶灰质体积表明,额叶病变可能比三个后叶的病变更严重,并且可能是精神分裂症相关前额叶功能障碍突出的原因。

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