Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Level 3, National Neuroscience Facility, Alan Gilbert Building, 161, Barry St, Carlton South, VIC, 3053, Australia.
Schizophr Res. 2011 Apr;127(1-3):46-57. doi: 10.1016/j.schres.2010.12.020.
Despite an increasing number of published voxel based morphometry studies of schizophrenia, there has been no adequate attempt to examine gray (GM) and white matter (WM) abnormalities and the heterogeneity of published findings. In the current article, we used a coordinate based meta-analysis technique to simultaneously examine GM and WM abnormalities in schizophrenia and to assess the effects of gender, chronicity, negative symptoms and other clinical variables. 79 studies meeting our inclusion criteria were included in the meta-analysis. Schizophrenia was associated with GM reductions in the bilateral insula/inferior frontal cortex, superior temporal gyrus, anterior cingulate gyrus/medial frontal cortex, thalamus and left amygdala. In WM analyses of volumetric and diffusion-weighted images, schizophrenia was associated with decreased FA and/or WM in interhemispheric fibers, anterior thalamic radiation, inferior longitudinal fasciculi, inferior frontal occipital fasciculi, cingulum and fornix. Male gender, chronic illness and negative symptoms were associated with more severe GM abnormalities and illness chronicity was associated with more severe WM deficits. The meta-analyses revealed overlapping GM and WM structural findings in schizophrenia, characterized by bilateral anterior cortical, limbic and subcortical GM abnormalities, and WM changes in regions including tracts that connect these structures within and between hemispheres. However, the available findings are biased towards characteristics of schizophrenia samples with poor prognosis.
尽管已有越来越多的基于体素的形态计量学研究探讨精神分裂症，但尚未有充分的尝试来检查灰质（GM）和白质（WM）的异常以及已发表研究结果的异质性。在当前的文章中，我们使用基于坐标的荟萃分析技术同时检查精神分裂症的 GM 和 WM 异常，并评估性别、慢性、阴性症状和其他临床变量的影响。符合我们纳入标准的 79 项研究被纳入荟萃分析。精神分裂症与双侧岛叶/额下回、颞上回、前扣带回/额内侧回、丘脑和左侧杏仁核的 GM 减少有关。在容积和弥散加权图像的 WM 分析中，精神分裂症与半脑间纤维、前丘脑辐射、下纵束、额枕下束、扣带回和穹窿的 FA 和/或 WM 减少有关。男性性别、慢性疾病和阴性症状与更严重的 GM 异常有关，而疾病慢性与更严重的 WM 缺陷有关。荟萃分析显示，精神分裂症存在重叠的 GM 和 WM 结构异常，表现为双侧前皮质、边缘和皮质下 GM 异常，以及包括连接这些结构的半球内和半球间束在内的区域的 WM 变化。然而，现有的研究结果偏向于预后不良的精神分裂症样本的特征。
