Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138 Naples, Italy.
Prog Neuropsychopharmacol Biol Psychiatry. 2012 Jun 1;37(2):264-9. doi: 10.1016/j.pnpbp.2012.02.003. Epub 2012 Feb 10.
Deficit schizophrenia (DS) represents a promising putative clinical subtype of schizophrenia and is characterized by the presence of primary and enduring negative symptoms. Previous studies have often reported a reduced amount of gray matter within prefrontal and temporal cortices in schizophrenia subjects with prevailing negative symptoms; however, the evidence concerning brain structural abnormalities in patients with DS remains controversial. The aim of the present study was to investigate whether patients with DS differed from those with nondeficit schizophrenia (NDS) with respect to the volume of the dorsolateral prefrontal cortex (DLPFC) and hippocampus, two brain areas considered as key regions in the pathogenesis of schizophrenia. In the present study a 3D-T1w MR imaging procedure and an extensive clinical assessment was carried out in 18 patients with schizophrenia, (10 DS and 8 NDS). 3D MPRAGE images were preprocessed with SPM software and two regions of interest (hippocampus and DLPFC) were manually traced to obtain their gray matter volumes. We found a significant reduction of DLPFC in the entire schizophrenia group, with respect to healthy subjects. Although the subgroup of patients with DS had a more severe clinical picture and more impaired social functioning, the DLPFC volume reduction was greater in NDS than in DS patients. In conclusion, according to our structural neuroimaging findings, DS patients, although characterized by a more severe clinical picture and a worse outcome, show less neurobiological abnormalities.
缺陷型精神分裂症(DS)代表了一种有前途的精神分裂症潜在临床亚型,其特征为存在原发性和持续性阴性症状。先前的研究经常报告在以阴性症状为主的精神分裂症患者的前额叶和颞叶皮质中存在灰质减少;然而,关于 DS 患者脑结构异常的证据仍然存在争议。本研究旨在探讨 DS 患者与非缺陷型精神分裂症(NDS)患者是否存在差异,具体表现在背外侧前额叶皮层(DLPFC)和海马体的体积上,这两个脑区被认为是精神分裂症发病机制的关键区域。在本研究中,对 18 名精神分裂症患者(10 名 DS 和 8 名 NDS)进行了 3D-T1wMR 成像和广泛的临床评估。3D MPRAGE 图像使用 SPM 软件进行预处理,并手动追踪两个感兴趣区(海马体和 DLPFC)以获得其灰质体积。我们发现,与健康受试者相比,整个精神分裂症组的 DLPFC 明显减少。尽管 DS 患者亚组的临床表现更严重,社会功能更受损,但 NDS 患者的 DLPFC 体积减少大于 DS 患者。总之,根据我们的结构神经影像学研究结果,尽管 DS 患者的临床表现更为严重,结局更差,但神经生物学异常较少。