Arango Celso, McMahon Robert P, Lefkowitz David M, Pearlson Godfrey, Kirkpatrick Brian, Buchanan Robert W
Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Unidad de Adolescentes, Dpto de Psiquiatría, c/ Ibiza 43, Madrid, Spain.
Psychiatry Res. 2008 Feb 28;162(2):91-100. doi: 10.1016/j.pscychresns.2007.06.002. Epub 2008 Jan 16.
Recent evidence suggests that schizophrenia reflects a neurodegenerative process. The studies have not compared brain change patterns in male and female patients with schizophrenia or examined the relation of these patterns to patient subgroups defined by specific symptom domains. Maximum Total Brain Volume (TBVmax), total cranial (TCV), total brain (TBV), sulcal CSF (sCSF), and ventricular (VV) volumes were measured in 66 normal controls (32 females, 34 males), and 85 patients with schizophrenia (21 females, 64 males). Sixty-six patients were categorized as nondeficit and 19 as deficit patients. Patients had smaller TBV and larger VV than normal controls. Patients also showed significant excessive brain volume loss after, but not before, TBVmax was achieved compared with normal controls. Although male patients had larger brain volume loss compared with male normal controls than female patients had compared with female normal controls, there were no significant gender x diagnosis interactions. Male patients with the deficit syndrome, but not those without the deficit syndrome, had significantly larger ventricles than normal controls. There were no other significant deficit/nondeficit differences. The present study suggests that brain volume loss in schizophrenia occurs after TBVmax and that male and female patients and deficit and nondeficit patients with schizophrenia do not demonstrate any differences in the time course of their brain volume reductions.
近期证据表明，精神分裂症反映了一种神经退行性过程。这些研究尚未比较精神分裂症男性和女性患者的脑变化模式，也未研究这些模式与由特定症状领域定义的患者亚组之间的关系。对66名正常对照者（32名女性，34名男性）和85名精神分裂症患者（21名女性，64名男性）测量了最大全脑体积（TBVmax）、总颅腔体积（TCV）、全脑体积（TBV）、脑沟脑脊液（sCSF）和脑室体积（VV）。66名患者被归类为非缺陷型，19名患者被归类为缺陷型。与正常对照者相比，患者的TBV较小，VV较大。与正常对照者相比，患者在达到TBVmax之后而非之前也显示出明显过多的脑体积损失。尽管与男性正常对照者相比，男性患者的脑体积损失比女性患者与女性正常对照者相比时更大，但不存在显著的性别×诊断交互作用。有缺陷综合征的男性患者而非无缺陷综合征的男性患者，其脑室明显大于正常对照者。不存在其他显著的缺陷型/非缺陷型差异。本研究表明，精神分裂症患者的脑体积损失发生在TBVmax之后，并且精神分裂症的男性和女性患者以及有缺陷和无缺陷的患者在脑体积减少的时间进程上没有任何差异。
