Rüsch Nicolas, Spoletini Ilaria, Wilke Marko, Martinotti Giovanni, Bria Pietro, Trequattrini Alberto, Bonaviri Giuseppina, Caltagirone Carlo, Spalletta Gianfranco
IRCCS Fondazione Santa Lucia, Rome, Italy.
Psychiatry Res. 2008 Dec 30;164(3):206-14. doi: 10.1016/j.pscychresns.2007.12.011. Epub 2008 Nov 13.
The neurobiology of suicidality in schizophrenia is largely unknown. We therefore assessed gray and white matter volumes associated with past suicidality and current self-aggression in schizophrenia. Fifty-five outpatients with schizophrenia (n=55) and healthy controls (n=55), matched for age, gender and handedness, were recruited. Ten patients had a life-time history of one or more suicide attempts. Current self-aggression was assessed using the Modified Overt Aggression Scale. High resolution structural magnetic resonance images were analyzed by voxel-based morphometry. We found significantly larger inferior frontal white matter volumes bilaterally in patients with a previous suicide attempt as compared with those patients without a history of suicidality. No other significant white or gray matter volume differences were observed. White matter volume in these regions did not differ between healthy controls and those patients without a previous suicide attempt. Furthermore, among patients, the level of current self-aggression showed a significant positive correlation with white matter volume in the same regions. Inferior frontal white matter alterations in fronto-temporo-limbic circuits may be associated with suicidality and self-aggression in schizophrenia.
精神分裂症患者自杀行为的神经生物学机制在很大程度上尚不清楚。因此，我们评估了与精神分裂症患者过去的自杀行为和当前的自我攻击行为相关的灰质和白质体积。招募了55名精神分裂症门诊患者（n = 55）和健康对照者（n = 55），并在年龄、性别和利手方面进行了匹配。10名患者有过一次或多次自杀未遂的终生病史。使用改良的公开攻击量表评估当前的自我攻击行为。通过基于体素的形态学分析高分辨率结构磁共振图像。我们发现，与没有自杀病史的患者相比，有过自杀未遂史的患者双侧额下回白质体积明显更大。未观察到其他显著的白质或灰质体积差异。这些区域的白质体积在健康对照者和没有自杀未遂史的患者之间没有差异。此外，在患者中，当前的自我攻击水平与同一区域的白质体积呈显著正相关。额颞叶边缘回路中的额下回白质改变可能与精神分裂症患者的自杀行为和自我攻击行为有关。
