Kawasaki Yasuhiro, Suzuki Michio, Nohara Shigeru, Hagino Hirofumi, Takahashi Tsutomu, Matsui Mie, Yamashita Ikiko, Chitnis Xavier A, McGuire Philip K, Seto Hikaru, Kurachi Masayoshi
Dept. of Neuropsychiatry, Toyama Medical & Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan.
Eur Arch Psychiatry Clin Neurosci. 2004 Dec;254(6):406-14. doi: 10.1007/s00406-004-0522-1. Epub 2004 Nov 12.
Brain abnormalities of schizophrenia probably consist of deviation related to the vulnerability and pathological changes in association with overt psychosis. We conducted a cross-sectional comparison in brain morphology between patients with overt schizophrenia and schizotypal disorder, a schizophrenia-spectrum disorder without florid psychotic episode. Voxelbased morphometry was applied to assess gray matter volume in 25 patients with schizophrenia, 25 patients with schizotypal disorder, and 50 healthy control subjects. In comparison with controls, schizophrenia patients showed gray matter reductions in the bilateral medial frontal, inferior frontal, medial temporal, and septal regions, and the left middle frontal, orbitofrontal, insula, and superior temporal regions, and an increased gray matter in the left basal ganglia. Schizotypal disorder patients showed reductions in the left inferior frontal, insula, superior temporal, and medial temporal regions. There was a significant reduction in the left orbitofrontal region of schizophrenia compared with schizotypal disorder. Gray matter reductions that are common to both patient groups such as those in the left medial temporal and inferior frontal regions may represent vulnerability to schizophrenia, and additional involvement of several frontal regions may be crucial to florid psychosis.
精神分裂症的脑部异常可能包括与易感性相关的偏差以及与明显精神病相关的病理变化。我们对患有明显精神分裂症的患者和分裂型障碍患者（一种没有明显精神病发作的精神分裂症谱系障碍）的脑形态进行了横断面比较。基于体素的形态测量法被用于评估25名精神分裂症患者、25名分裂型障碍患者和50名健康对照者的灰质体积。与对照组相比，精神分裂症患者在双侧内侧额叶、额下回、内侧颞叶和隔区，以及左侧额中回、眶额回、岛叶和颞上回出现灰质减少，而左侧基底神经节的灰质增加。分裂型障碍患者在左侧额下回、岛叶、颞上回和内侧颞叶区域出现减少。与分裂型障碍相比，精神分裂症患者的左侧眶额回区域有显著减少。两个患者组共有的灰质减少，如左侧内侧颞叶和额下回区域的减少，可能代表对精神分裂症的易感性，而几个额叶区域的额外受累可能对明显的精神病至关重要。
