Asami Takeshi, Narita Hiroyuki, Hirayasu Yoshio
Department of Psychiatry, Yokohama City University School of Medicine.
Seishin Shinkeigaku Zasshi. 2004;106(8):987-96.
One hundred years ago, Kraepelin hypothesized that cerebral damage might cause dementia praecox. Many patients with schizophrenia show progressive clinical deterioration, although the evidence has remained unclear for the organic brain damage. Recently, brain abnormalities have been suggested, including enlargement of the lateral ventricles and reduction of the frontal and temporal lobes, due to the development of magnetic resonance imaging (MRI). Changes in brain structures have also been reported in the clinical course of schizophrenia. These structural brain studies have played important roles in clarifying the pathophysiology of schizophrenia and understanding the association of clinical symptoms with morphological brain change. However, there have been inconsistencies in the results on progressive structural changes. The selection of the patients, effects of medication, and social environmental factors may account for these inconsistencies. We have reviewed recent studies that found structural changes in the brain, including subcortical and ventricular of the schizophrenia.
一百年前,克雷佩林提出假说,认为脑损伤可能导致早发性痴呆。许多精神分裂症患者表现出临床症状的进行性恶化,尽管关于器质性脑损伤的证据仍不明确。最近,由于磁共振成像(MRI)技术的发展,人们发现了一些脑异常情况,包括侧脑室扩大以及额叶和颞叶萎缩。在精神分裂症的临床病程中也报告了脑结构的变化。这些脑结构研究在阐明精神分裂症的病理生理学以及理解临床症状与脑形态变化之间的关联方面发挥了重要作用。然而,关于进行性结构变化的研究结果存在不一致性。患者的选择、药物治疗的影响以及社会环境因素可能是造成这些不一致性的原因。我们回顾了近期发现精神分裂症患者脑结构变化的研究,包括皮层下和脑室的变化。