Friedman L, Lys C, Schulz S C
Department of Psychiatry, Case Western Reserve University, University Hospitals of Cleveland, OH 44106.
J Psychiatry Neurosci. 1992 Jun;17(2):42-54.
Over the last decade, a number of studies have attempted to relate brain morphology to treatment response to neuroleptics. This approach has scientific potential to define subtypes of schizophrenia as well as potential clinical utility. In the present report, a review of 33 studies, including a meta-analysis, is provided. Although the overall test of the effect was not significant, the analysis revealed marked heterogeneity in the results of the various studies. The following factors were significant predictors of effect size: age, illness duration and age of onset of the patient cohort, the percentage of patients with marked structural abnormality included in the study overall, the duration of treatment and the degree of symptom improvement in the study overall. The following factors were unrelated to study effect size: date of study, gender, and the presence of a washout period. In future studies, attention to the parameters utilized in the meta-analysis should help to clarify the strength and generality of the relationship between brain morphology and treatment response.
在过去十年中，多项研究试图将脑形态与抗精神病药物的治疗反应联系起来。这种方法在定义精神分裂症亚型以及潜在临床应用方面具有科学潜力。在本报告中，提供了对33项研究的综述，包括一项荟萃分析。尽管总体效应检验不显著，但分析显示各项研究结果存在明显异质性。以下因素是效应大小的显著预测指标：患者队列的年龄、病程和发病年龄、研究总体中纳入的有明显结构异常的患者百分比、治疗持续时间以及研究总体中的症状改善程度。以下因素与研究效应大小无关：研究日期、性别以及是否存在洗脱期。在未来的研究中，关注荟萃分析中使用的参数应有助于阐明脑形态与治疗反应之间关系的强度和普遍性。
