Wang Lei, Mamah Daniel, Harms Michael P, Karnik Meghana, Price Joseph L, Gado Mokhtar H, Thompson Paul A, Barch Deanna M, Miller Michael I, Csernansky John G
Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Biol Psychiatry. 2008 Dec 15;64(12):1060-8. doi: 10.1016/j.biopsych.2008.08.007. Epub 2008 Sep 23.
Progressive decreases in cortical gray matter volume have been reported in schizophrenia. However, studies of progressive change in deep brain nuclei and hippocampal-amygdala formation have not yielded consistent findings.
Two high-resolution, T1-weighted magnetic resonance images were collected 2 years apart in 56 schizophrenia and 62 control subjects. Large-deformation high-dimensional brain mapping was used to generate surfaces for deep brain nuclei and hippocampal-amygdala formation at baseline and follow-up. Repeated-measures analysis of variance was used to test for longitudinal changes in volume and shape.
The pattern of progressive changes in the deep brain nuclei and hippocampal-amygdala formation in schizophrenia and control subjects was variable. Of the structures that receive direct projections from the cortex, the thalamus, caudate nucleus, nucleus accumbens, and hippocampus showed changes specific to subjects with schizophrenia, and changes in the amygdala and putamen were similar in both groups. Although different at baseline, no progressive change was observed in the globus pallidus, which does not receive direct projections from the cortex.
These findings suggest that the disease process of schizophrenia is associated with progressive effects on brain structure and that brain structures that receive direct, excitatory connections from the cortex may be more likely to show progressive changes, compared with brain structures that receive indirect, inhibitory connections from the cortex. These findings are also somewhat consistent with the hypothesis that overactivity of excitatory pathways in the brain may contribute to the neural degeneration that occurs in at least a subgroup of individuals with schizophrenia.
已有报道称精神分裂症患者的皮质灰质体积会逐渐减少。然而，关于深部脑核团和海马 - 杏仁核结构的渐进性变化的研究尚未得出一致的结果。
对56名精神分裂症患者和62名对照者相隔2年采集了两张高分辨率T1加权磁共振图像。使用大变形高维脑图谱在基线期和随访期生成深部脑核团和海马 - 杏仁核结构的表面。采用重复测量方差分析来测试体积和形状的纵向变化。
精神分裂症患者和对照者深部脑核团和海马 - 杏仁核结构的渐进性变化模式各不相同。在接受来自皮质直接投射的结构中，丘脑、尾状核、伏隔核和海马表现出精神分裂症患者特有的变化，而杏仁核和壳核在两组中的变化相似。苍白球虽然在基线期有所不同，但未观察到渐进性变化，它不接受来自皮质的直接投射。
这些发现表明，精神分裂症的疾病过程与对脑结构的渐进性影响有关，与接受来自皮质间接抑制性连接的脑结构相比，接受来自皮质直接兴奋性连接的脑结构可能更有可能出现渐进性变化。这些发现也在一定程度上与以下假设一致，即大脑中兴奋性通路的过度活跃可能导致至少一部分精神分裂症患者发生神经退行性变。
