McClure Robert K, Phillips Ingrid, Jazayerli Roukan, Barnett Allan, Coppola Richard, Weinberger Daniel R
University of North Carolina at Chapel Hill, Department of Psychiatry, Chapel Hill, NC 27510-7160, USA.
Psychiatry Res. 2006 Dec 1;148(2-3):121-32. doi: 10.1016/j.pscychresns.2006.04.008. Epub 2006 Nov 9.
The purpose of this pilot study was to: (1) determine if regional brain volume change occurs in schizophrenia patients during very short periods of withdrawal from, or stable treatment with, antipsychotics, and; (2) compare results of region-of-interest (ROI) to voxel-based morphometry (VBM) methods. In two small groups of schizophrenic inpatients, magnetic resonance imaging was performed before and after antipsychotic withdrawal, and at two time points during stable chronic antipsychotic treatment. Regional brain volumes were measured using ROI methods. Grey matter volume was measured with VBM. The medication withdrawal group showed no effect of treatment state or antipsychotic type on regional brain volumes with ROI analysis, but effects of both treatment state and antipsychotic type on grey matter volume were observed with VBM in right middle frontal, right medial frontal, right and left superior frontal, right cingulate, and right superior temporal gyrii as well as in the right and left hippocampal gyrii. The chronic stable treatment group showed an effect of time on right caudate, left hippocampal, and total cerebrospinal fluid volumes with ROI analysis, while effects of both time and antipsychotic type were observed with VBM on grey matter volume in the left superior temporal lobe. No findings survived correction for multiple comparisons. A positive correlation between regional volume change and emerging psychopathology was demonstrated using ROI methods in the medication withdrawal group. Treatment state and emergent symptoms in schizophrenia patients were associated with regional volume change over very short time periods. Longitudinal regional brain volume change in schizophrenia patients is likely physiologic and therefore potentially reversible.
（1）确定精神分裂症患者在短期停用抗精神病药物或接受稳定治疗期间，大脑区域体积是否会发生变化；（2）比较感兴趣区域（ROI）方法与基于体素的形态计量学（VBM）方法的结果。在两组小型精神分裂症住院患者中，在停用抗精神病药物前后以及稳定的慢性抗精神病药物治疗期间的两个时间点进行了磁共振成像。使用ROI方法测量大脑区域体积。用VBM测量灰质体积。在ROI分析中，停药组未发现治疗状态或抗精神病药物类型对大脑区域体积有影响，但在VBM分析中，观察到治疗状态和抗精神病药物类型对右侧额中回、右侧额内侧回、左右额上回、右侧扣带回、右侧颞上回以及左右海马回的灰质体积均有影响。在慢性稳定治疗组中，ROI分析显示时间对右侧尾状核、左侧海马以及脑脊液总体积有影响，而VBM分析显示时间和抗精神病药物类型对左侧颞上叶的灰质体积均有影响。经多重比较校正后，未发现有统计学意义的结果。在停药组中，使用ROI方法证明了区域体积变化与新出现的精神病理学之间存在正相关。精神分裂症患者的治疗状态和新出现的症状与极短时间内的区域体积变化有关。精神分裂症患者大脑区域体积的纵向变化可能是生理性的，因此可能是可逆的。
