van Haren Neeltje E M, Hulshoff Pol Hilleke E, Schnack Hugo G, Cahn Wiepke, Brans Rachel, Carati Inge, Rais Monica, Kahn René S
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands.
Biol Psychiatry. 2008 Jan 1;63(1):106-13. doi: 10.1016/j.biopsych.2007.01.004. Epub 2007 Jun 27.
Considering the magnitude of the reported changes in brain volume over time in first-episode patients it is unlikely that these changes are constant over the life-span of the schizophrenic illness. Thus, one would expect the progression in brain volume change in schizophrenia to follow a more complex trajectory over time.
Two magnetic resonance imaging brain scans were obtained over a 5-year interval of 96 schizophrenia patients and 113 healthy subjects between ages 16 to 56.
The trajectory of brain volume change differed between patients with schizophrenia and healthy individuals. Before the age of 45 years cerebral and gray matter loss and lateral ventricle increase were excessive in patients relative to controls, representing approximately the first 20 years of illness. Patients showed an excessive third ventricle volume increase over time. In addition, poor outcome patients showed more brain tissue loss during the follow-up interval than good outcome patients.
Cerebral (gray) matter volume loss in the patients was mainly characterized by the absence of the normal curved trajectory of volume change with age that was present in healthy subjects. Later in life, the degree of volume change in patients is similar to that observed with normal aging. Independently of age, larger brain volume changes appear clinically relevant.
考虑到首发患者脑容量随时间变化的报道幅度，这些变化在精神分裂症病程中不太可能是恒定的。因此，可以预期精神分裂症患者脑容量变化的进展会随时间遵循更复杂的轨迹。
在16至56岁的96名精神分裂症患者和113名健康受试者的5年间隔内进行了两次磁共振成像脑部扫描。
精神分裂症患者和健康个体的脑容量变化轨迹不同。在45岁之前，相对于对照组，患者的脑实质和灰质损失以及侧脑室增大过度，约占疾病的前20年。随着时间的推移，患者的第三脑室容积过度增加。此外，预后不良的患者在随访期间比预后良好的患者脑组织损失更多。
患者脑（灰质）体积减少的主要特征是缺乏健康受试者中随年龄增长而出现的正常的脑容量变化曲线轨迹。在生命后期，患者的脑容量变化程度与正常衰老时观察到的相似。独立于年龄，更大的脑容量变化在临床上似乎具有相关性。
