Bakalar Jennifer L, Greenstein Deanna K, Clasen Liv, Tossell Julia W, Miller Rachel, Evans Alan C, Mattai Anand A, Rapoport Judith L, Gogtay Nitin
Child Psychiatry Branch, NIMH, NIH, Rm 3N202, Bethesda, MD 20892-1600, USA.
Schizophr Res. 2009 Nov;115(1):12-6. doi: 10.1016/j.schres.2009.07.026. Epub 2009 Sep 5.
Childhood-onset schizophrenia (COS) is a rare, severe form of the adult-onset illness, with more salient neurobiological causes. Previous cross-sectional structural neuroimaging research has suggested that normal cortical asymmetry patterns [(R-L)/(R+L)] may be altered in adult schizophrenia, although these findings were not well replicated. Recent studies show dynamic changes in brain asymmetry during childhood and adolescence. We hypothesized that COS patients would show a lack of normal development of asymmetry and decreased overall asymmetry.
Prospective structural magnetic resonance scans were obtained at baseline and at two-year follow-up visits in 49 right-handed COS patients (mean baseline age: 14.72+/-2.63, 117 scans) and 50 age and sex-matched, right-handed healthy controls (mean baseline age: 15.15+/-3.37, 125 scans). Cortical thickness was calculated at 40,962 homologous points across each cerebral hemisphere using a fully automated, validated method. Differences in developmental asymmetry patterns across the cortical surface were analyzed using a linear mixed effects regression model.
No significant asymmetry differences were found either for cross-sectional comparisons of COS and healthy controls across the lateral and medial cortical surfaces or with respect to timing of developmental changes in asymmetry.
The present findings do not support asymmetry differences for this severe, early form of schizophrenia.
儿童期起病的精神分裂症(COS)是成人起病型疾病的一种罕见且严重的形式,具有更为显著的神经生物学病因。以往的横断面结构神经影像学研究表明,成人精神分裂症患者的正常皮质不对称模式[(右侧-左侧)/(右侧+左侧)]可能会发生改变,尽管这些发现并未得到很好的重复验证。最近的研究显示,儿童期和青少年期大脑不对称存在动态变化。我们假设COS患者会表现出不对称正常发育的缺失以及整体不对称性降低。
对49名右利手COS患者(平均基线年龄:14.72±2.63岁,共117次扫描)和50名年龄及性别匹配的右利手健康对照者(平均基线年龄:15.15±3.37岁,共125次扫描)在基线期和两年随访期进行前瞻性结构磁共振扫描。使用一种经过验证的全自动方法,在每个大脑半球的40962个对应点计算皮质厚度。使用线性混合效应回归模型分析皮质表面发育不对称模式的差异。
无论是对COS患者和健康对照者在外侧和内侧皮质表面进行横断面比较,还是关于不对称发育变化的时间,均未发现显著的不对称差异。
目前的研究结果不支持这种严重的早发型精神分裂症存在不对称差异。