Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.
Eur Neuropsychopharmacol. 2010 Dec;20(12):855-65. doi: 10.1016/j.euroneuro.2010.08.008. Epub 2010 Sep 22.
Cerebral grey matter volume reductions are progressive in schizophrenia, with larger grey matter volume decreases associated with cannabis use. It is unknown whether this grey matter loss is globally distributed over the entire brain or more pronounced in specific cortical brain regions. Fifty-one patients with recent-onset schizophrenia and 31 matched healthy subjects were included. For all subjects, magnetic resonance imaging scans were obtained at inclusion and at 5-year follow-up. Nineteen patients (ab-)used cannabis but no other illicit drugs; 32 patients and the healthy comparison subjects did not use any drugs during the 5-year follow-up. At follow-up, clinical outcome was measured. To evaluate the local differences in cortical thickness change over five years between the two groups regression analysis was carried out over the cortical surface. At inclusion cortical thickness did not differ between patients and controls and between cannabis-using and non-using patients. Over the follow-up period we found excessive thinning of the right supplementary motor cortex, inferior frontal cortex, superior temporal gyrus, angular gyrus, occipital and parietal lobe in patients relative to controls after controlling for cannabis use. Patients who used cannabis showed additional thinning in the left dorsolateral prefrontal cortex (DLPFC), left anterior cingulate cortex (ACC) and left occipital lobe as compared to those patients that did not use cannabis during the scan interval. First-episode schizophrenia patients who use cannabis show a more pronounced cortical thinning than non-using patients in areas known for their high density of CB1 receptors, such as the ACC and the DLPFC.
精神分裂症患者的大脑灰质体积不断减少，而大麻的使用与更大的灰质体积减少有关。目前尚不清楚这种灰质损失是在整个大脑中普遍分布，还是在特定的皮质脑区更为明显。本研究纳入了 51 名首发精神分裂症患者和 31 名匹配的健康对照者。所有受试者在纳入时和 5 年随访时均进行了磁共振成像扫描。19 名患者（滥用）大麻但不使用其他非法药物；32 名患者和健康对照组在 5 年随访期间未使用任何药物。在随访时，评估了临床结局。为了评估两组患者在 5 年内皮质厚度变化的局部差异，我们在皮质表面进行了回归分析。在纳入时，患者和对照组之间以及使用大麻和不使用大麻的患者之间的皮质厚度没有差异。在随访期间，我们发现，与对照组相比，在控制了大麻使用情况后，患者的右侧辅助运动皮质、下额叶皮质、上颞叶、角回、枕叶和顶叶在随访期间过度变薄。与未在扫描间隔内使用大麻的患者相比，使用大麻的患者在左侧背外侧前额叶皮质（DLPFC）、左侧前扣带皮质（ACC）和左侧枕叶出现了额外的变薄。与不使用大麻的患者相比，使用大麻的首发精神分裂症患者在 ACC 和 DLPFC 等 CB1 受体密度较高的区域出现了更明显的皮质变薄。
