Kasai Kiyoto, Shenton Martha E, Salisbury Dean F, Hirayasu Yoshio, Lee Chang-Uk, Ciszewski Aleksandra A, Yurgelun-Todd Deborah, Kikinis Ron, Jolesz Ferenc A, McCarley Robert W
Clinical Neuroscience Division, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, Harvard Medical School, Brockton, MA 02301, USA.
Am J Psychiatry. 2003 Jan;160(1):156-64. doi: 10.1176/appi.ajp.160.1.156.
Smaller temporal lobe cortical gray matter volumes, including the left superior temporal gyrus, have been reported in magnetic resonance imaging (MRI) studies of patients with chronic schizophrenia and, more recently, in patients with first-episode schizophrenia. However, it remains unknown whether there are progressive decreases in temporal lobe cortical gray matter volumes in patients with first-episode schizophrenia and whether similarly progressive volume decreases are present in patients with affective psychosis.
High-spatial-resolution MRI scans at initial hospitalization and 1.5 years later were obtained from 13 patients with first-episode schizophrenia, 15 patients with first-episode affective psychosis (mainly manic), and 14 healthy comparison subjects. MRI volumes were calculated for gray matter of superior temporal gyrus and for the amygdala-hippocampal complex.
Patients with first-episode schizophrenia showed significant decreases in gray matter volume over time in the left superior temporal gyrus compared with patients with first-episode affective psychosis or healthy comparison subjects. This progressive decrease was more pronounced in the posterior portion of the left superior temporal gyrus (mean=9.6%) than in the anterior portions (mean=8.4%). No group differences in the rate of change over time were present in other regions.
These findings demonstrate a progressive volume reduction of the left posterior superior temporal gyrus gray matter in patients with first-episode schizophrenia but not in patients with first-episode affective psychosis.
在慢性精神分裂症患者的磁共振成像(MRI)研究中,以及最近在首发精神分裂症患者的研究中,均报告了包括左侧颞上回在内的颞叶皮质灰质体积减小。然而,首发精神分裂症患者的颞叶皮质灰质体积是否会进行性减小,以及情感性精神病患者是否也存在类似的进行性体积减小,目前尚不清楚。
对13例首发精神分裂症患者、15例首发情感性精神病(主要为躁狂发作)患者和14名健康对照者在初次住院时及1.5年后进行了高空间分辨率MRI扫描。计算颞上回灰质以及杏仁核 - 海马复合体的MRI体积。
与首发情感性精神病患者或健康对照者相比,首发精神分裂症患者的左侧颞上回灰质体积随时间显著减小。这种进行性减小在左侧颞上回后部(平均=9.6%)比在前部(平均=8.4%)更为明显。其他区域在随时间变化率方面无组间差异。
这些发现表明,首发精神分裂症患者左侧颞上回后部灰质体积会进行性减少,而首发情感性精神病患者则不会。