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首发精神分裂症患者一年随访时的灰质形态与功能水平。

Gray matter morphology and the level of functioning in one-year follow-up of first-episode schizophrenia patients.

机构信息

Department of Psychiatry, Masaryk University, Faculty of Medicine and Faculty Hospital Brno-Bohunice, Brno, Czech Republic.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2009 Nov 13;33(8):1438-46. doi: 10.1016/j.pnpbp.2009.07.025. Epub 2009 Aug 6.

Abstract

UNLABELLED

Schizophrenia is a condition with a highly variable course that is hard to predict. The aim of the present study was to investigate if local gray matter volume (GMV) can differentiate poor (PF) and good (GF) functioning patients using voxel-wise analysis in a group of first-episode schizophrenia subjects (FES).

METHOD

32 FES male patients were assessed twice: at the time of the first episode of schizophrenia and one year later. 18 healthy controls matched for age, gender, and handedness were also included. Local gray matter volume was analyzed using voxel-wise full-factorial design with factors group (GF, PF) and time.

RESULTS

FES subjects had bilateral gray matter reduction in the lateral prefrontal cortex as compared with healthy controls. PF subjects had smaller GMV in the left orbitofrontal and frontopolar cortex.

CONCLUSION

GMV in the left prefrontal cortex differentiates later poor and good functioning schizophrenia patients. Morphological analysis might be considered a candidate for a biological marker in outcome prediction. However, the small sample size, and the lack of female subjects limit generalization of results. Moreover, studies analyzing the predictive value of brain morphology on a single-subject level should be performed to assess its real usefulness in outcome prediction.

摘要

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精神分裂症是一种病程高度多变、难以预测的疾病。本研究旨在通过对首发精神分裂症患者(FES)进行基于体素的分析,探讨局部灰质体积(GMV)是否可以区分功能较差(PF)和功能较好(GF)的患者。

方法

32 名首发精神分裂症男性患者接受了两次评估:首次精神分裂症发作时和一年后。还纳入了 18 名年龄、性别和惯用手相匹配的健康对照者。使用基于体素的全因子设计,用因素组(GF、PF)和时间来分析局部灰质体积。

结果

与健康对照组相比,FES 患者双侧外侧前额皮质灰质减少。PF 患者左侧眶额和额极皮质 GMV 较小。

结论

左侧前额皮质的 GMV 可区分精神分裂症患者的后期功能较差和较好。形态分析可能被视为预后预测的生物标志物候选。然而,样本量小,缺乏女性受试者限制了结果的推广。此外,应该进行分析脑形态对个体水平预测价值的研究,以评估其在预后预测中的实际有用性。

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