Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Nussbaumstrasse 7, Munich, Germany.
Eur Arch Psychiatry Clin Neurosci. 2010 Mar;260(2):127-37. doi: 10.1007/s00406-009-0023-3. Epub 2009 Jun 3.
Several studies have demonstrated that structural brain change is detectable in the hippocampus in both patients, with schizophrenia and major depression. Only few studies, however, compared both clinical disease entities directly and no larger study has tried to take different disease stages into account. The objectives of this study are to investigate whether hippocampal volumes are reduced in patients with schizophrenia and those with major depression with the same duration of illness compared to healthy controls and to assess further changes at different disease stages. A total of 319 inpatients and healthy controls were enrolled and investigated with magnetic resonance imaging (MRI). Hippocampal volumes were measured using the segmentation software BRAINS. Bilateral hippocampal volume reductions were detected in both schizophrenic and depressed patients compared to healthy control (HC) subjects. Although younger, schizophrenic (SZ) patients showed in their MRI scans significant bilaterally reduced hippocampal volumes compared to patients with major depression. Although the hippocampal reductions were similar at the onset of symptomatic manifestation of both diseases, there was a further significant reduction of the left hippocampus in the recurrently ill SZ subgroup. The data suggest rather dynamic structural brain alterations in schizophrenia compared to major depression. Here, the presented application of the comparative neuroscience approach, by the use of large neuroimaging MRI databases, seems highly valuable. In the field of psychiatry, with its still controversial operationalized descriptive diagnostic entities, the cross-nosological approach provides a helpful tool to better elucidate the still unknown brain pathologies and their underlying molecular mechanisms beyond a single nosological entity.
几项研究表明，精神分裂症和重度抑郁症患者的海马体都存在结构脑变化。然而，只有少数研究直接比较了这两种临床疾病实体，而且没有更大的研究试图考虑不同的疾病阶段。本研究的目的是调查在疾病持续时间相同的情况下，精神分裂症和重度抑郁症患者的海马体体积是否比健康对照组减少，并评估不同疾病阶段的进一步变化。共有 319 名住院患者和健康对照组接受了磁共振成像（MRI）检查。使用分割软件 BRAINS 测量海马体体积。与健康对照组（HC）相比，精神分裂症和抑郁症患者的双侧海马体体积均减少。尽管年龄较小，精神分裂症（SZ）患者的 MRI 扫描显示双侧海马体体积明显小于重度抑郁症患者。尽管两种疾病症状表现开始时的海马体减少相似，但反复发作的 SZ 亚组的左侧海马体进一步显著减少。数据表明，与重度抑郁症相比，精神分裂症的结构脑变化更为活跃。这里，通过使用大型神经影像学 MRI 数据库，应用比较神经科学方法似乎具有很高的价值。在精神病学领域，其操作性描述性诊断实体仍存在争议，跨疾病方法为阐明仍未知的大脑病理学及其潜在的分子机制提供了一个有用的工具，超越了单一的疾病实体。
