Rüsch Nicolas, Tebartz van Elst Ludger, Valerius Gabi, Büchert Martin, Thiel Thorsten, Ebert Dieter, Hennig Jürgen, Olbrich Hans-Martin
Department of Psychiatry and Psychotherapy, University of Freiburg, Germany.
Schizophr Res. 2008 Feb;99(1-3):155-63. doi: 10.1016/j.schres.2007.05.024. Epub 2007 Jul 6.
Executive dysfunction is a core feature of schizophrenia. The neurochemical and structural changes associated with this deficit are, however, largely unclear. This study tested the hypothesis that changes in glutamate, glutamine and N-acetyl-aspartate (NAA) in hippocampal and dorsolateral prefrontal (DLPFC) regions as well as hippocampal, amygdalar and DLPFC volume reductions are associated with executive dysfunction.
Twenty-nine subjects with schizophrenia and 31 healthy controls were examined by short-echo single voxel magnetic resonance spectroscopy of the left anterior hippocampus and the left DLPFC. Volumes of the hippocampi, amygdalae and DLPFC were measured bilaterally using manual volumetry. Executive functioning was assessed by the Wisconsin Card Sorting Test (WCST).
Poor WCST performance was associated with increased hippocampal glutamate concentrations among subjects with schizophrenia, not among healthy controls. Glutamate in the DLPFC as well as NAA or glutamine in the hippocampus or the DLPFC were not related to executive functioning in schizophrenia or healthy controls. Reduced amygdalar volume was associated with impaired executive functioning in subjects with schizophrenia (p=.06) and healthy controls (p=.04).
Altered hippocampal glutamatergic neurotransmission and amygdalar volume loss may be associated with executive dysfunction in schizophrenia.
执行功能障碍是精神分裂症的核心特征。然而，与这种缺陷相关的神经化学和结构变化在很大程度上尚不清楚。本研究检验了以下假设：海马体和背外侧前额叶（DLPFC）区域中谷氨酸、谷氨酰胺和N-乙酰天门冬氨酸（NAA）的变化以及海马体、杏仁核和DLPFC体积减小与执行功能障碍有关。
对29名精神分裂症患者和31名健康对照者进行了左侧前海马体和左侧DLPFC的短回波单体素磁共振波谱检查。使用手工容积测量法双侧测量海马体、杏仁核和DLPFC的体积。通过威斯康星卡片分类测验（WCST）评估执行功能。
在精神分裂症患者中，WCST表现不佳与海马体谷氨酸浓度升高有关，而在健康对照者中则不然。DLPFC中的谷氨酸以及海马体或DLPFC中的NAA或谷氨酰胺与精神分裂症患者或健康对照者的执行功能无关。杏仁核体积减小与精神分裂症患者（p = 0.06）和健康对照者（p = 0.04）的执行功能受损有关。
海马体谷氨酸能神经传递改变和杏仁核体积减小可能与精神分裂症的执行功能障碍有关。
