University Hospital Marqués de Valdecilla, CIBERSAM, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.
Psychol Med. 2011 Jul;41(7):1449-60. doi: 10.1017/S003329171000200X. Epub 2010 Oct 14.
The thickness of the cortical mantle is a sensitive measure for identifying alterations in cortical structure. We aimed to explore whether first episode schizophrenia patients already show a significant cortical thinning and whether cortical thickness anomalies may significantly influence clinical and cognitive features.
We investigated regional changes in cortical thickness in a large and heterogeneous sample of schizophrenia spectrum patients (n=142) at their first break of the illness and healthy controls (n=83). Magnetic resonance imaging brain scans (1.5 T) were obtained and images were analyzed by using brains2. The contribution of sociodemographic, cognitive and clinical characterictics was investigated.
Patients showed a significant total cortical thinning (F=17.55, d=-0.62, p<0.001) and there was a diffuse pattern of reduced thickness (encompassing frontal, temporal and parietal cortices) (all p's<0.001, d's>0.53). No significant group×gender interactions were observed (all p's>0.15). There were no significant associations between the clinical and pre-morbid variables and cortical thickness measurements (all r's<0.12). A weak significant negative correlation between attention and total (r=-0.24, p=0.021) and parietal cortical thickness (r=-0.27, p=0.009) was found in patients (thicker cortex was associated with lower attention). Our data revealed a similar pattern of cortical thickness changes related to age in patients and controls.
Cortical thinning is independent of gender, age, age of onset and duration of the illness and does not seem to significantly influence clinical and functional symptomatology. These findings support a primary neurodevelopment disorder affecting the normal cerebral cortex development in schizophrenia.
皮质厚度是识别皮质结构改变的敏感指标。我们旨在探讨首发精神分裂症患者是否已经出现明显的皮质变薄，以及皮质厚度异常是否会显著影响临床和认知特征。
我们对大量异质的精神分裂症谱系患者（n=142）和健康对照组（n=83）在疾病首次发作时进行了皮质厚度的区域变化研究。获得了磁共振成像脑部扫描（1.5T），并使用 brains2 进行了图像分析。我们调查了社会人口统计学、认知和临床特征的贡献。
患者表现出明显的总皮质变薄（F=17.55，d=-0.62，p<0.001），并且存在弥漫性的厚度减少模式（包括额叶、颞叶和顶叶皮质）（所有 p 值均<0.001，d 值均>0.53）。未观察到组×性别交互作用（所有 p 值均>0.15）。临床和发病前变量与皮质厚度测量之间没有显著关联（所有 r 值<0.12）。在患者中，注意力与总皮质厚度（r=-0.24，p=0.021）和顶叶皮质厚度（r=-0.27，p=0.009）之间存在弱显著负相关，表明皮质越厚，注意力越低。我们的数据显示了患者和对照组与年龄相关的皮质厚度变化的相似模式。
皮质变薄与性别、年龄、发病年龄和病程无关，似乎不会显著影响临床和功能症状。这些发现支持一种主要的神经发育障碍，影响精神分裂症患者正常大脑皮质的发育。
