Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, Brockton, Massachusetts, USA.
Neuroimage. 2012 Jan 16;59(2):986-96. doi: 10.1016/j.neuroimage.2011.08.066. Epub 2011 Sep 5.
Region of Interest (ROI) longitudinal studies have detected progressive gray matter (GM) volume reductions in patients with first-episode schizophrenia (FESZ). However, there are only a few longitudinal voxel-based morphometry (VBM) studies, and these have been limited in ability to detect relationships between volume loss and symptoms, perhaps because of methodologic issues. Nor have previous studies compared and validated VBM results with manual Region of Interest (ROI) analysis. In the present VBM study, high-dimensional warping and individualized baseline-rescan templates were used to evaluate longitudinal volume changes within subjects and compared with longitudinal manual ROI analysis on the same subjects. VBM evaluated thirty-three FESZ and thirty-six matched healthy control subjects (HC) at baseline (cross-sectionally) and longitudinally evaluated 21 FESZ and 23 HC after an average of 1.5 years from baseline scans. Correlation analyses detected the relationship between changes in regional GM volumes in FESZ and clinical symptoms derived from the Brief Psychiatric Rating Scale, as well as cognitive function as assessed by the Mini-Mental State Examination. At baseline, patients with FESZ had significantly smaller GM volume compared to HC in some regions including the left superior temporal gyrus (STG). On rescan after 1.5 years, patients showed significant GM volume reductions compared with HC in the left STG including Heschl's gyrus, and in widespread brain neocortical regions of frontal, parietal, and limbic regions including the cingulate gyrus. FESZ showed an association of positive symptoms and volume loss in temporal (especially STG) and frontal regions, and negative symptoms and volume loss in STG and frontal regions. Worse cognitive function was linked to widespread volume reduction, in frontal, temporal and parietal regions. The validation VBM analyses showed results similar to our previous ROI findings for STG and cingulate gyrus. We conclude FESZ show widespread, progressive GM volume reductions in many brain regions. Importantly, these reductions are directly associated with a worse clinical course. Congruence with ROI analyses suggests the promise of this longitudinal VBM methodology.
感兴趣区（ROI）纵向研究已经在首发精神分裂症（FESZ）患者中检测到灰质（GM）体积进行性减少。然而，仅有少数纵向基于体素的形态测量学（VBM）研究，并且这些研究在检测体积损失与症状之间的关系方面能力有限，这可能是由于方法学问题所致。以前的研究也没有比较和验证 VBM 结果与手动 ROI 分析。在本 VBM 研究中，使用高维变形和个体化基线-重扫模板来评估受试者内的纵向体积变化，并将其与同一受试者的纵向手动 ROI 分析进行比较。VBM 在基线（横截面）评估了 33 名 FESZ 和 36 名匹配的健康对照者（HC），并在基线扫描后平均 1.5 年对 21 名 FESZ 和 23 名 HC 进行了纵向评估。相关性分析检测了 FESZ 中区域性 GM 体积变化与源自简明精神病评定量表的临床症状之间的关系，以及简易精神状态检查评估的认知功能之间的关系。在基线时，与 HC 相比，FESZ 患者在包括左侧颞上回（STG）在内的一些区域中 GM 体积明显较小。在 1.5 年后的重新扫描中，与 HC 相比，患者在包括 Heschl 回在内的左侧 STG 以及额、顶和边缘区域的广泛脑新皮层区域（包括扣带回）中 GM 体积明显减少。FESZ 显示在颞叶（特别是 STG）和额叶区域的阳性症状和体积减少之间存在关联，并且在 STG 和额叶区域存在阴性症状和体积减少。较差的认知功能与额、颞和顶叶的广泛体积减少有关。验证性 VBM 分析显示出与我们之前 STG 和扣带回 ROI 发现相似的结果。我们得出的结论是，FESZ 在许多脑区中显示出广泛的、进行性的 GM 体积减少。重要的是，这些减少与更严重的临床过程直接相关。与 ROI 分析的一致性表明这种纵向 VBM 方法学具有很大的前景。
