Pagsberg A K, Baaré W F C, Raabjerg Christensen A M, Fagerlund B, Hansen M-B, Labianca J, Krabbe K, Aarkrog T, Paulson O B, Hemmingsen R P
Department of Child and Adolescent Psychiatry, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.
J Neural Transm (Vienna). 2007;114(4):489-98. doi: 10.1007/s00702-006-0573-8. Epub 2006 Oct 6.
Brain morphometry in children and adolescents with first-episode psychosis offer a unique opportunity for pathogenetic investigations.
We compared high-resolution 3D T1-weighted magnetic resonance images of the brain in 29 patients (schizophrenia, schizotypal disorder, delusional disorder or other non-organic psychosis), aged 10-18 to those of 29 matched controls, using optimized voxel-based morphometry.
Psychotic patients had frontal white matter abnormalities, but expected (regional) gray matter reductions were not observed. Post hoc analyses revealed that schizophrenia patients (n = 15) had significantly larger lateral ventricles as compared to controls. Duration and dose of antipsychotics correlated negatively with global gray matter volume in minimally medicated patients (n = 18).
Findings of white matter changes and enlarged lateral ventricles already at illness onset in young schizophrenia spectrum patients, suggests aberrant neurodevelopmental processes in the pathogenesis of these disorders. Gray matter volume changes, however, appear not to be a key feature in early onset first-episode psychosis.
对首发精神病的儿童和青少年进行脑形态测量为病因学研究提供了独特的机会。
我们使用优化的基于体素的形态测量法，将29例年龄在10至18岁的患者（精神分裂症、分裂型障碍、妄想性障碍或其他非器质性精神病）的高分辨率3D T1加权磁共振脑图像与29例匹配的对照组进行比较。
精神病患者存在额叶白质异常，但未观察到预期的（局部）灰质减少。事后分析显示，与对照组相比，精神分裂症患者（n = 15）的侧脑室明显更大。在用药最少的患者（n = 18）中，抗精神病药物的使用时间和剂量与全脑灰质体积呈负相关。
年轻的精神分裂症谱系患者在疾病发作时就出现白质变化和侧脑室扩大的结果，表明这些疾病的发病机制中存在异常的神经发育过程。然而，灰质体积变化似乎不是早发性首发精神病的关键特征。
