Schizophrenia Research Division, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, USA.
Curr Opin Psychiatry. 2011 Mar;24(2):100-6. doi: 10.1097/YCO.0b013e328342c8e0.
Aggression in schizophrenia is associated with poor treatment outcomes, hospital admissions, and stigmatization of patients. As such it represents an important public health issue. This article reviews recent neuroimaging studies of aggression in schizophrenia, focusing on PET/single photon emission computed tomography and MRI methods.
The neuroimaging literature on aggression in schizophrenia is in a period of development. This is attributable in part to the heterogeneous nature and basis of that aggression. Radiological methods have consistently shown reduced activity in frontal and temporal regions. MRI brain volumetric studies have been less consistent, with some studies finding increased volumes of inferior frontal structures, and others finding reduced volumes in aggressive individuals with schizophrenia. Functional MRI studies have also had inconsistent results, with most finding reduced activity in inferior frontal and temporal regions, but some also finding increased activity in other regions. Some studies have made a distinction between types of aggression in schizophrenia in the context of antisocial traits, and this appears to be useful in understanding the neuroimaging literature.
Frontal and temporal abnormalities appear to be a consistent feature of aggression in schizophrenia, but their precise nature likely differs because of the heterogeneous nature of that behavior.
精神分裂症患者的攻击性与较差的治疗效果、住院和患者污名化有关。因此，它代表了一个重要的公共卫生问题。本文综述了最近关于精神分裂症攻击性的神经影像学研究，重点介绍了正电子发射断层扫描/单光子发射计算机断层扫描和磁共振成像方法。
精神分裂症攻击性的神经影像学文献正处于发展阶段。这部分归因于该攻击性的异质性性质和基础。影像学方法一致显示额叶和颞叶区域活动减少。磁共振脑容积研究则不太一致，一些研究发现下额叶结构体积增加，而另一些研究发现攻击性精神分裂症个体的体积减小。功能磁共振成像研究也有不一致的结果，大多数研究发现下额叶和颞叶区域活动减少，但也有一些研究发现其他区域活动增加。一些研究在反社会特征的背景下对精神分裂症的攻击类型进行了区分，这似乎有助于理解神经影像学文献。
额叶和颞叶异常似乎是精神分裂症攻击性的一个一致特征，但由于这种行为的异质性，其确切性质可能不同。
