Boos Heleen B M, Aleman André, Cahn Wiepke, Hulshoff Pol Hilleke, Kahn René S
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, 3508 GA Utrecht, the Netherlands.
Arch Gen Psychiatry. 2007 Mar;64(3):297-304. doi: 10.1001/archpsyc.64.3.297.
Smaller brain volumes have consistently been found in patients with schizophrenia, particularly in gray matter and medial temporal lobe structures. Although several studies have investigated brain volumes in nonpsychotic relatives of patients with schizophrenia, results have been inconsistent.
To determine the magnitude and extent of brain volume differences in first-degree relatives of schizophrenic patients.
A systematic search was conducted to identify relevant studies. Computer searches of the MEDLINE database were performed for English-language articles published before July 2005. Relevant abstracts published in 2005 were also selected.
Magnetic resonance imaging studies that examined differences in brain volumes between first-degree relatives of patients with schizophrenia and healthy control subjects were obtained through computerized databases, including MEDLINE. Studies had to report sufficient data for computation of effect sizes.
For each study, the Cohen d was calculated. Data extraction and calculation of the effect size were performed by 2 authors (H.B.M.B. and A.A.) who reached a consensus in cases of uncertainty and discrepancies. All analyses were performed using the random-effects model.
Twenty-five studies were identified as suitable for analysis and included 1065 independent first-degree relatives of patients, 679 patients with schizophrenia, and 1100 healthy control subjects. The largest difference between relatives and healthy control subjects was found in hippocampal volume, with relatives having smaller volumes than controls (d = 0.31; 95% confidence interval [CI], 0.13-0.49; 9 effect sizes). Gray matter was smaller (d = 0.18; 95% CI, 0.02-0.33; 7 effect sizes) and third-ventricle volume was larger (d = 0.21; 95% CI, 0.03-0.40; 7 effect sizes) in relatives compared with healthy control subjects.
Brain abnormalities are present in nonpsychotic first-degree relatives of patients with schizophrenia and are most pronounced in the hippocampus.
一直以来，精神分裂症患者的脑容量较小，尤其是灰质和内侧颞叶结构。尽管有多项研究调查了精神分裂症患者非精神病性亲属的脑容量，但结果并不一致。
确定精神分裂症患者一级亲属脑容量差异的大小和范围。
进行了系统检索以识别相关研究。对MEDLINE数据库进行计算机检索，查找2005年7月之前发表的英文文章。还选择了2005年发表的相关摘要。
通过包括MEDLINE在内的计算机数据库，获取了检查精神分裂症患者一级亲属与健康对照者脑容量差异的磁共振成像研究。研究必须报告足够的数据以计算效应量。
对于每项研究，计算Cohen d值。数据提取和效应量计算由两位作者（H.B.M.B.和A.A.）进行，在存在不确定性和差异的情况下达成共识。所有分析均使用随机效应模型进行。
确定了25项适合分析的研究，包括1065名患者的独立一级亲属、679名精神分裂症患者和1100名健康对照者。亲属与健康对照者之间最大的差异在于海马体体积，亲属的海马体体积小于对照者（d = 0.31；95%置信区间[CI]，0.13 - 0.49；9个效应量）。与健康对照者相比，亲属的灰质较小（d = 0.18；95% CI，0.02 - 0.33；7个效应量），第三脑室体积较大（d = 0.21；95% CI，0.03 - 0.40；7个效应量）。
精神分裂症患者的非精神病性一级亲属存在脑异常，且在海马体中最为明显。
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