Department of Psychiatry and Psychotherapy, Friedrich-Schiller-University of Jena, Philosophenweg 3, D-07743 Jena, Germany.
Schizophr Bull. 2012 Jun;38(4):838-44. doi: 10.1093/schbul/sbq140. Epub 2011 Feb 4.
Although mostly conceptualized as a neurodevelopmental disorder, there is an increasing interest in progressive changes of cognitive deficits and brain structure and function in schizophrenia across the life span.
In this study, we investigated age-related changes in regional gray matter using voxel-based morphometry in a sample of 99 patients (age range 18-65 years) with Diagnostic and Statistical Manual of Mental Disorders-IV schizophrenia and 113 healthy controls (age range 19-59 years) using a cross-sectional design.
We found steeper age-related decline in gray matter in patients in a cluster comprising the left superior temporal cortex and adjacent inferior parietal lobule. We then divided the schizophrenia sample in 3 subgroups based on a 3-factor model of psychopathology ratings. Age-related changes were markedly different in each of the 3 subgroups (compared with healthy controls). While patients with predominantly paranoid symptoms showed stronger age-related progression in the left superior temporal cortex and right inferior frontal gyrus, those of the disorganized subgroup had stronger gray matter loss in the left lateral cerebellum, while the predominantly negative subgroup showed minor effects in the left superior temporal gyrus.
Our findings show that differences in brain structural changes associated with aging diverge between schizophrenia patients and healthy subjects and that different subgroups within a patient sample might be at higher risk of age-related regional gray matter loss.
尽管精神分裂症主要被概念化为一种神经发育障碍,但人们越来越关注精神分裂症患者在整个生命周期中认知缺陷和大脑结构与功能的进行性变化。
在这项研究中,我们采用基于体素的形态测量学方法,在 99 名符合《精神障碍诊断与统计手册》第 4 版精神分裂症诊断标准的患者(年龄范围为 18-65 岁)和 113 名健康对照者(年龄范围为 19-59 岁)中研究了与年龄相关的区域性灰质变化,使用的是横断面设计。
我们发现,在一个包括左颞上回和相邻的下顶叶的脑区中,患者的灰质与年龄的相关性下降更为陡峭。然后,我们根据精神病理学评分的 3 因素模型将精神分裂症样本分为 3 个亚组。与健康对照组相比,每个亚组的与年龄相关的变化都明显不同。以偏执症状为主的患者在左颞上回和右侧额下回表现出更强的与年龄相关的进展,而以紊乱症状为主的患者在左侧外侧小脑表现出更强的灰质丢失,而以阴性症状为主的患者在左侧颞上回的影响较小。
我们的研究结果表明,与年龄相关的大脑结构变化的差异在精神分裂症患者和健康受试者之间存在差异,而且患者样本中的不同亚组可能更容易出现与年龄相关的区域性灰质丢失。