Nesvåg Ragnar, Frigessi Arnoldo, Jönsson Erik G, Agartz Ingrid
Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
Schizophr Res. 2007 Feb;90(1-3):52-61. doi: 10.1016/j.schres.2006.11.008. Epub 2007 Jan 10.
Magnetic resonance imaging (MRI) studies have shown smaller volumes of grey matter (GM) and white matter (WM) both in schizophrenia and among patients with alcohol abuse or dependence. The effect of alcohol consumption in non-clinical alcohol consumers, i.e. subjects not recruited as having alcohol use disorders is less studied. In the present study, we investigated the effects of alcohol consumption, antipsychotic medication and a diagnosis of schizophrenia on variation in brain volumes among patients recruited for having schizophrenia and a group of age and gender matched control subjects. A total of 69 patients with schizophrenia (n=56), schizoaffective disorder (n=12) and schizophreniform disorder (n=1) and 97 control subjects were included. Alcohol Use Disorder Identification Test (AUDIT) was used to estimate alcohol consumption. In the entire group of patients and controls higher AUDIT score was significantly related to smaller volumes of WM. When ten patients and six control subjects who met lifetime diagnostic criteria for alcohol use disorders were excluded only a trend level association between AUDIT score and WM volumes was found. Having a diagnosis of schizophrenia was related to smaller volumes of total, frontal and temporal WM, total and temporal GM, and larger volumes of total, frontal and temporal cerebrospinal fluid (CSF). A diagnosis of schizophrenia remained a significant factor for smaller WM volumes even when the effect of alcohol consumption was taken into account. Antipsychotic medication was related to larger volumes of temporal CSF. This study demonstrates that alcohol consumption is an important factor for variation in WM volumes, and this effect should be taken into account in all studies evaluating brain volumes from MR images.
磁共振成像（MRI）研究表明，精神分裂症患者以及酒精滥用或依赖患者的灰质（GM）和白质（WM）体积均较小。对于非临床饮酒者，即未被招募为患有酒精使用障碍的受试者，饮酒的影响研究较少。在本研究中，我们调查了饮酒、抗精神病药物治疗以及精神分裂症诊断对招募的精神分裂症患者和一组年龄及性别匹配的对照受试者脑容量变化的影响。总共纳入了69例患有精神分裂症（n = 56）、分裂情感性障碍（n = 12）和精神分裂症样障碍（n = 1）的患者以及97名对照受试者。使用酒精使用障碍识别测试（AUDIT）来评估饮酒量。在整个患者组和对照组中，较高的AUDIT评分与较小的WM体积显著相关。当排除10例符合酒精使用障碍终生诊断标准的患者和6名对照受试者后，仅发现AUDIT评分与WM体积之间存在趋势水平的关联。患有精神分裂症与总、额叶和颞叶WM体积较小、总及颞叶GM体积较小以及总、额叶和颞叶脑脊液（CSF）体积较大有关。即使考虑饮酒的影响，精神分裂症诊断仍然是WM体积较小的一个重要因素。抗精神病药物治疗与颞叶CSF体积较大有关。本研究表明，饮酒是WM体积变化的一个重要因素，在所有评估MRI图像脑容量的研究中都应考虑到这一影响。
