Ha Tae Hyon, Youn Tak, Ha Kyoo Seob, Rho Kyu Sik, Lee Jong Min, Kim In Young, Kim Sun I, Kwon Jun Soo
Department of Psychiatry, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, South Korea.
Psychiatry Res. 2004 Dec 30;132(3):251-60. doi: 10.1016/j.pscychresns.2004.05.001.
Numerous imaging studies have shown structural brain abnormalities in schizophrenia. Recently, voxel-based morphometry enabled whole brain analysis beyond the regions of interest (ROI). Regional gray matter concentrations of magnetic resonance (MR) images from 35 patients with paranoid schizophrenia were compared with those from 35 age- and sex-matched controls, and their clinical correlations were explored using voxel-based morphometry. Gray matter concentrations in the patients were significantly reduced in the left insular and dorsolateral prefrontal regions, and bilaterally in the medial frontal, anterior cingulate, inferior frontal and superior temporal regions. On the other hand, gray matter concentrations in the bilateral cerebellum and right striatum were significantly increased in the patients compared with controls. A negative correlation between the score for the severity of 'lack of insight and judgment' and gray matter concentrations in the left posterior and right anterior cingulate and bilateral inferior temporal regions including the lateral fusiform gyri was found. These results suggest the important roles of the paralimbic structures in the pathophysiology of schizophrenia and the involvement of the perceptual and monitoring systems in the mechanism of insight.
大量影像学研究已表明精神分裂症患者存在脑结构异常。最近，基于体素的形态测量学能够对感兴趣区域（ROI）以外的全脑进行分析。将35例偏执型精神分裂症患者的磁共振（MR）图像的区域灰质浓度与35例年龄和性别匹配的对照组进行比较，并使用基于体素的形态测量学探讨它们的临床相关性。患者的灰质浓度在左侧岛叶和背外侧前额叶区域显著降低，并在内侧额叶、前扣带回、额下回和颞上回双侧降低。另一方面，与对照组相比，患者双侧小脑和右侧纹状体的灰质浓度显著增加。发现“缺乏洞察力和判断力”严重程度评分与左侧后部和右侧前部扣带回以及包括外侧梭状回在内的双侧颞下回区域的灰质浓度呈负相关。这些结果表明边缘旁结构在精神分裂症病理生理学中的重要作用以及感知和监测系统在洞察力机制中的参与。
