Centre for Neuroimaging Sciences, Institute of Psychiatry, King's College London, UK.
Schizophr Res. 2010 Jul;120(1-3):54-62. doi: 10.1016/j.schres.2010.03.036. Epub 2010 May 26.
Lateral ventricular enlargement is one of the most consistent findings in patients with schizophrenia; however whether progressive ventricular dilation occurs during the course of the illness has been controversial. To clarify this we conducted a meta-analysis of longitudinal studies measuring the lateral ventricles in patients with schizophrenia and a control group.
The MEDLINE database was searched from 1980 to 2009 for longitudinal MRI studies of patients with schizophrenia. We identified 13 studies that measured the lateral ventricles in both patients and controls and these were included in a random effects meta-analysis. The effect of various clinical variables was investigated in a meta-regression analysis.
Patients showed evidence of progressive ventricular enlargement after illness onset greater than that seen in controls (effect size=0.45, 95%CI 0.19-0.71, p=0.0006). A sub-analysis of chronic patients with schizophrenia with a mean duration of illness of 7.6 years at baseline scan also showed progressive ventricular enlargement (p=0.002). The results were robust to inclusion criteria, and no significant effect of age of onset, duration of illness, or age at baseline scan, was found in the meta-regression analysis.
The meta-analysis shows progressive changes in ventricular volume a number of years after illness onset and challenges an exclusively neurodevelopmental model of schizophrenia.
侧脑室扩大是精神分裂症患者最常见的发现之一；然而，疾病过程中是否会发生进行性脑室扩张一直存在争议。为了澄清这一点，我们对测量精神分裂症患者和对照组侧脑室的纵向研究进行了荟萃分析。
从 1980 年到 2009 年，我们在 MEDLINE 数据库中搜索了关于精神分裂症患者纵向 MRI 研究的文献。我们确定了 13 项测量患者和对照组侧脑室的纵向研究，并将这些研究纳入随机效应荟萃分析。在荟萃回归分析中，我们研究了各种临床变量的影响。
患者在发病后表现出比对照组更大的进行性脑室扩大的证据（效应大小=0.45，95%CI 0.19-0.71，p=0.0006）。对基线扫描时平均病程为 7.6 年的慢性精神分裂症患者的亚分析也显示出进行性脑室扩大（p=0.002）。结果在纳入标准中是稳健的，荟萃回归分析中未发现发病年龄、病程或基线扫描年龄的显著影响。
荟萃分析显示，在发病后数年出现了脑室容积的进行性变化，这对精神分裂症的纯神经发育模型提出了挑战。
