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研究影响精神分裂症患者脑室扩大的因素:一项 20 年随访的荟萃分析。

Study factors influencing ventricular enlargement in schizophrenia: a 20 year follow-up meta-analysis.

机构信息

Laboratory of Neuro Imaging (LONI), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, 635 Charles E. Young Drive SW, Suite 225, Los Angeles, CA 90095-7334, USA.

出版信息

Neuroimage. 2012 Jan 2;59(1):154-67. doi: 10.1016/j.neuroimage.2011.07.011. Epub 2011 Jul 20.

Abstract

A meta-analysis was performed on studies employing the ventricular-brain ratio to compare schizophrenic subjects to that of normal controls. This was a follow-up to a similar meta-analysis published in 1992 in which study-, in addition to clinical-, factors were found to contribute significantly to the reported difference between patients with schizophrenia and controls. Seventy-two (N=72) total studies were identified from the peer reviewed literature, 39 from the original meta-analysis, and 33 additional studies published since which met strict criteria for inclusion and analysis - thus representing ~30 years of schizophrenia ventricular enlargement research. Sample characteristics from schizophrenics and controls were coded for use as predictor variables against within sample VBR values as well as for between sample VBR differences. Additionally, a number of factors concerning how the studies were conducted and reported were also coded. Obtained data was subjected to unweighted univariate as well as multiple regression analyses. In particular, results indicated significant differences between schizophrenics and controls in ventricular size but also the influence of the diagnostic criteria used to define schizophrenia on the magnitude of the reported VBR. This suggests that differing factors of the diagnostic criteria may be sensitive to ventricular enlargement and might be worthy of further examination. Interestingly, we observed an inverse relationship between VBR difference and the number of co-authors on the study. This latter finding suggests that larger research groups report smaller VBR differences and may be more conservative or exacting in their research methodology. Analyses weighted by sample size provided identical conclusions. The effects of study factors such as these are helpful for understanding the variation in the size of the reported differences in VBR between patients and controls as well as for understanding the evolution of research on complex clinical syndromes employing neuroimaging morphometrics.

摘要

对使用脑室-大脑比率来比较精神分裂症患者与正常对照组的研究进行了荟萃分析。这是对 1992 年发表的类似荟萃分析的后续研究,该研究发现,除了临床因素外,研究因素也对报告的精神分裂症患者与对照组之间的差异有显著贡献。从同行评议文献中确定了 72 项(N=72)研究,其中 39 项来自原始荟萃分析,另外 33 项是自那时以来发表的符合严格纳入和分析标准的研究,代表了约 30 年的精神分裂症脑室扩大研究。从精神分裂症患者和对照组中获取样本特征,作为预测变量,针对样本内 VBR 值以及样本间 VBR 差异进行编码。此外,还对研究的进行方式和报告方式进行了编码。对获得的数据进行了未加权的单变量和多元回归分析。特别是,结果表明,精神分裂症患者和对照组在脑室大小方面存在显著差异,但用于定义精神分裂症的诊断标准也对报告的 VBR 幅度有影响。这表明诊断标准的不同因素可能对脑室扩大敏感,值得进一步研究。有趣的是,我们观察到 VBR 差异与研究作者人数之间存在反比关系。这一发现表明,更大的研究小组报告的 VBR 差异较小,并且在研究方法上可能更加保守或严格。按样本量加权的分析得出了相同的结论。这些研究因素的影响有助于理解报告的患者与对照组之间 VBR 差异大小的变化,以及理解采用神经影像学形态计量学研究复杂临床综合征的研究进展。

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