Yoshihara Yujiro, Sugihara Genichi, Matsumoto Hideo, Suckling John, Nishimura Katsuhiko, Toyoda Takao, Isoda Haruo, Tsuchiya Kenji J, Takebayashi Kiyokazu, Suzuki Katsuaki, Sakahara Harumi, Nakamura Kazuhiko, Mori Norio, Takei Nori
Department of Psychiatry and Neurology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Ann Gen Psychiatry. 2008 Dec 22;7:25. doi: 10.1186/1744-859X-7-25.
Investigation into the whole brain morphology of early onset schizophrenia (EOS) to date has been sparse. We studied the regional brain volumes in EOS patients, and the correlations between regional volume measures and symptom severity.
A total of 18 EOS patients (onset under 16 years) and 18 controls matched for age, gender, parental socioeconomic status, and height were examined. Voxel-based morphometric analysis using the Brain Analysis Morphological Mapping (BAMM) software package was employed to explore alterations of the regional grey (GM) and white matter (WM) volumes in EOS patients. Symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS).
EOS patients had significantly reduced GM volume in the left parahippocampal, inferior frontal, and superior temporal gyri, compared with the controls. They also had less WM volume in the left posterior limb of the internal capsule and the left inferior longitudinal fasciculus. The positive symptom score of PANSS (higher values corresponding to more severe symptoms) was negatively related to GM volume in the bilateral posterior cingulate gyrus. The negative symptom score was positively correlated with GM volume in the right thalamus. As for the association with WM volume, the positive symptom score of PANSS was positively related to cerebellar WM (vermis region), and negatively correlated with WM in the brain stem (pons) and in the bilateral cerebellum (hemisphere region).
Our findings of regional volume alterations of GM and WM in EOS patients coincide with those of previous studies of adult onset schizophrenia patients. However, in brain regions that had no overall structural differences between EOS patients and controls (that is, the bilateral posterior cingulate gyrus, the right thalamus, the cerebellum, and the pons), within-subject analysis of EOS patients alone revealed that there were significant associations of the volume in these areas and the symptom severity. These findings suggest that at an early stage of the illness, especially for those with onset before brain maturation, a wide range of disturbed neural circuits, including these brain regions that show no apparent morphological changes, may contribute to the formation of the symptomatology.
迄今为止，对早发性精神分裂症（EOS）全脑形态的研究较少。我们研究了EOS患者的脑区体积，以及区域体积测量值与症状严重程度之间的相关性。
共检查了18例EOS患者（发病年龄在16岁以下）和18名年龄、性别、父母社会经济地位及身高相匹配的对照者。使用脑分析形态学图谱（BAMM）软件包进行基于体素的形态学分析，以探索EOS患者脑区灰质（GM）和白质（WM）体积的变化。使用阳性和阴性症状量表（PANSS）评估症状。
与对照组相比，EOS患者左侧海马旁回、额下回和颞上回的GM体积显著减少。他们左侧内囊后肢和左侧下纵束的WM体积也较小。PANSS的阳性症状评分（值越高，症状越严重）与双侧扣带回后部的GM体积呈负相关。阴性症状评分与右侧丘脑的GM体积呈正相关。至于与WM体积的关联，PANSS的阳性症状评分与小脑WM（蚓部区域）呈正相关，与脑干（脑桥）和双侧小脑（半球区域）的WM呈负相关。
我们关于EOS患者GM和WM区域体积改变的研究结果与先前对成人发病精神分裂症患者的研究结果一致。然而，在EOS患者和对照者之间没有整体结构差异的脑区（即双侧扣带回后部、右侧丘脑、小脑和脑桥），仅对EOS患者进行的受试者内分析显示，这些区域的体积与症状严重程度之间存在显著关联。这些发现表明，在疾病的早期阶段，尤其是对于那些在大脑成熟之前发病的患者，包括这些没有明显形态变化的脑区在内的广泛神经回路紊乱可能导致症状的形成。
