University of New South Wales Research Unit for Schizophrenia Epidemiology, O'Brien Centre at St. Vincent's Hospital, 394-404 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia.
Neurosci Biobehav Rev. 2012 Apr;36(4):1342-56. doi: 10.1016/j.neubiorev.2011.12.015. Epub 2012 Jan 8.
The large quantity of systematic reviews of magnetic resonance imaging studies in schizophrenia challenges their meaningful interpretation. This meta-review synthesises the available information from systematic reviews of structural alteration in both chronic and first-episode schizophrenia.
Systematic reviews were identified using electronic databases. Review methodological quality was assessed according to the Assessment of Multiple Systematic Reviews checklist. Data were extracted in duplicate and quality assessed for consistency and precision, guided by Grading of Recommendations Assessment, Development and Evaluation recommendations.
Integration of volumetric and voxel-based estimates allowed critical assessment of the magnitude and location of anatomical differences. There is evidence for grey matter reductions of anterior cingulate, frontal (particularly medial and inferior) and temporal lobes, hippocampus/amygdala, thalamus, and insula that may be magnified over time. Other regional alterations appear specific to illness stage or medication status.
There is limited high quality evidence supporting grey or white matter changes in schizophrenia, which has previously been obscured by a large volume of conflicting lower quality evidence.
大量关于精神分裂症磁共振成像研究的系统评价对其有意义的解释提出了挑战。本元分析综合了慢性期和首发期精神分裂症结构改变的系统评价中的现有信息。
通过电子数据库确定系统评价。根据多系统评价评估检查表评估综述方法学质量。根据推荐评估、制定和评估分级指南，对数据进行重复提取和一致性及精确性评估。
体积和体素估计的综合使我们能够对解剖差异的程度和位置进行关键评估。有证据表明，前扣带回、额叶（特别是内侧和下侧）和颞叶、海马/杏仁核、丘脑和脑岛的灰质减少，可能随着时间的推移而扩大。其他区域的改变似乎与疾病阶段或药物状态有关。
有有限的高质量证据支持精神分裂症的灰质或白质变化，以前这些变化被大量相互矛盾的低质量证据所掩盖。
