Child Psychiatry Branch, National Institutes of Health, Bethesda, MD 20892, USA.
Am J Psychiatry. 2011 Apr;168(4):427-35. doi: 10.1176/appi.ajp.2010.10050681. Epub 2011 Jan 18.
Previous anatomic studies have established a reduction in hippocampal volume in schizophrenia, but few have investigated the progressive course of these changes and whether they are trait markers. In the present study, the authors examined hippocampal volumes in relation to age for patients with childhood-onset schizophrenia, their nonpsychotic healthy siblings, and healthy comparison subjects.
Anatomic brain magnetic resonance scans were obtained in childhood-onset schizophrenia probands (N=89, 198 scans), their nonpsychotic full siblings (N=78, 172 scans), and matched healthy comparison subjects (N=79, 198 scans) between the ages of 10 and 29 years. Total, left, and right hippocampal volumes were measured using FreeSurfer software and analyzed using a linear mixed-model regression covarying for sex and intracranial volume.
Childhood-onset schizophrenia probands had a fixed reduction in hippocampal volumes (total, left, and right) relative to both nonpsychotic siblings and healthy comparison subjects, whereas there were no significant volumetric or trajectory differences between nonpsychotic siblings and healthy comparison subjects.
Fixed hippocampal volume loss seen in childhood-onset schizophrenia, which is not shared by healthy siblings, appears to be related to the illness. Decreased hippocampal volume is not strongly genetically related but represents an important intermediate disease phenotype.
之前的解剖学研究已经证实精神分裂症患者的海马体体积减小,但很少有研究调查这些变化的进展过程以及它们是否是特征性标志物。本研究作者研究了与年龄相关的海马体体积,研究对象为起病于儿童期的精神分裂症患者、他们未患精神病的健康兄弟姐妹以及健康对照者。
对 89 名起病于儿童期的精神分裂症患者(198 次扫描)、78 名非精神病性健康同胞(172 次扫描)和 79 名匹配的健康对照者(198 次扫描)在 10 至 29 岁之间进行了脑部磁共振成像扫描。使用 FreeSurfer 软件测量总、左、右海马体体积,并使用线性混合模型回归分析,协变量为性别和颅内体积。
与非精神病性同胞和健康对照者相比,起病于儿童期的精神分裂症患者的海马体体积(总、左、右)存在固定性减小,而非精神病性同胞和健康对照者之间的体积或轨迹无显著差异。
起病于儿童期的精神分裂症患者存在固定的海马体体积减小,这与疾病有关,健康的兄弟姐妹并没有出现这种情况。海马体体积减小与遗传关系不大,但代表了一个重要的中间疾病表型。