Buchsbaum Monte S, Shihabuddin Lina, Brickman Adam M, Miozzo Ruben, Prikryl Radovan, Shaw Robert, Davis Kenneth
Department of Psychiatry, Mount Sinai School of Medicine, Box 1505, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA.
Schizophr Res. 2003 Nov 1;64(1):53-62. doi: 10.1016/s0920-9964(02)00526-1.
Magnetic resonance images of 37 patients with schizophrenia and 37 age- and sex-matched volunteers were acquired. The caudate nucleus and putamen were traced on axial slices from the most superior extent of the caudate to the most inferior point where the caudate and putamen merge. Two subtypes of schizophrenia were compared, the Kraepelinian subtype (n=13), characterized by an unremitting and severe course, and the non-Kraepelinian subtype (n=24), characterized by a remitting course and some periods of self-care. Patients with good outcome schizophrenia had larger relative mean putamen size (0.0129) than poor outcome patients (0.0123) or normal controls (0.0121), but not caudate size. This enlargement was most marked for the dorsal putamen and right hemisphere. Striatal size was not related to whether patients were currently being treated with atypical or typical neuroleptics or whether they had been predominantly treated with typical or atypical neuroleptics over the past 3 years. This suggests the possibility that the expansion of putamen size may be a physiological correlate of neuroleptic responsiveness or that small putamen size at disease onset may be a predictor of outcome.
获取了37例精神分裂症患者及37名年龄和性别匹配的志愿者的磁共振图像。从尾状核的最上端到尾状核与壳核融合的最下端，在轴位切片上描绘尾状核和壳核。比较了精神分裂症的两种亚型，克雷佩林亚型（n = 13），其特征为病程持续且严重，以及非克雷佩林亚型（n = 24），其特征为病程缓解且有一些自理期。预后良好的精神分裂症患者的壳核相对平均大小（0.0129）大于预后不良患者（0.0123）或正常对照（0.0121），但尾状核大小无差异。这种增大在背侧壳核和右半球最为明显。纹状体大小与患者当前是否接受非典型或典型抗精神病药物治疗，或过去3年中是否主要接受典型或非典型抗精神病药物治疗无关。这表明壳核大小扩大可能是抗精神病药物反应性的生理相关因素，或者疾病发作时壳核较小可能是预后的预测指标。
