Servicio de Psiquiatría, Hospital Universitario de Salamanca, Salamanca, Spain.
Psychiatry Res. 2010 Oct 30;184(1):16-22. doi: 10.1016/j.pscychresns.2010.06.006. Epub 2010 Sep 15.
The long-term outcome of schizophrenia patients may differ depending on their brain structure. This would be reflected in significant structural differences between poor-outcome (i.e., Kraepelinian) and non-Kraepelinian patients. To assess this possibility, we have evaluated the degree of deviation in brain structure in Kraepelinian patients with respect to controls and non-Kraepelinian schizophrenia patients. We used voxel-brain morphometry (VBM) to assess the differences in gray matter volume across the brain in the Kraepelinian group with respect to the healthy controls and non-Kraepelinian patients. Twenty-six Kraepelinian and 18 non-Kraepelinian schizophrenia patients and 41 healthy controls were included. With respect to the healthy controls, the Kraepelinian patients showed a very significant decrease in gray matter in the frontal, occipital, and limbic cortices, and, at a subcortical level, bilaterally in the striatum and thalamus. In comparison with the non-Kraepelinian patients, the Kraepelinian individuals continued to show a similar subcortical decrease. Thus, Kraepelinian patients may be characterized by a distinct pattern of brain abnormalities, in particular, in subcortical regions.
精神分裂症患者的长期预后可能因大脑结构而异。这将反映在预后不良（即克雷丕林式）和非克雷丕林式患者之间存在显著的结构差异。为了评估这种可能性，我们评估了克雷丕林式患者的大脑结构偏离程度，与对照组和非克雷丕林式精神分裂症患者进行比较。我们使用体素脑形态计量学（VBM）来评估克雷丕林式组与健康对照组和非克雷丕林式患者在全脑灰质体积上的差异。共纳入 26 名克雷丕林式和 18 名非克雷丕林式精神分裂症患者以及 41 名健康对照者。与健康对照组相比，克雷丕林式患者在前额、枕叶和边缘皮质以及皮质下水平的纹状体和丘脑双侧的灰质明显减少。与非克雷丕林式患者相比，克雷丕林式个体继续表现出类似的皮质下减少。因此，克雷丕林式患者可能具有独特的脑异常模式，特别是在皮质下区域。
