Nenadic Igor, Maitra Raka, Langbein Kerstin, Dietzek Maren, Lorenz Carsten, Smesny Stefan, Reichenbach Jürgen R, Sauer Heinrich, Gaser Christian
Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
Schizophr Res. 2015 Jul;165(2-3):212-9. doi: 10.1016/j.schres.2015.04.007. Epub 2015 Apr 29.
While schizophrenia and bipolar disorder have been assumed to share phenotypic and genotypic features, there is also evidence for overlapping brain structural correlates, although it is unclear whether these relate to shared psychotic features. In this study, we used voxel-based morphometry (VBM8) in 34 schizophrenia patients, 17 euthymic bipolar I disorder patients (with a history of psychotic symptoms), and 34 healthy controls. Our results indicate that compared to healthy controls schizophrenia patients show grey matter deficits (p<0.05, FDR corrected) in medial and right dorsolateral prefrontal, as well as bilaterally in ventrolateral prefrontal and insular cortical areas, thalamus (bilaterally), left superior temporal cortex, and minor medial parietal and parietooccipital areas. Comparing schizophrenia vs. bipolar I patients (p<0.05, FDR corrected) yielded a similar pattern, however, there was an additional significant reduction in schizophrenia patients in the (posterior) hippocampus bilaterally, left dorsolateral prefrontal cortex, and left cerebellum. Compared to healthy controls, the deficits in bipolar I patients only reached significance at p<0.001 (uncorr.) for a minor parietal cluster, but not for prefrontal areas. Our results suggest that the more extensive prefrontal, thalamic, and hippocampal deficits that might set apart schizophrenia and bipolar disorder might not be related to mere appearance of psychotic symptoms at some stage of the disorders.
虽然精神分裂症和双相情感障碍被认为具有表型和基因型特征，也有证据表明它们在脑结构相关性方面存在重叠，尽管尚不清楚这些是否与共同的精神病性特征有关。在本研究中，我们对34名精神分裂症患者、17名心境正常的双相I型障碍患者（有精神病性症状病史）和34名健康对照者使用了基于体素的形态学测量方法（VBM8）。我们的结果表明，与健康对照相比，精神分裂症患者在内侧和右侧背外侧前额叶、双侧腹外侧前额叶和岛叶皮质区域、丘脑（双侧）、左侧颞上叶皮质以及内侧顶叶和顶枕叶小区域存在灰质缺损（p<0.05，经FDR校正）。比较精神分裂症患者与双相I型障碍患者（p<0.05，经FDR校正）得到了类似的模式，然而，精神分裂症患者在双侧（后）海马体、左侧背外侧前额叶皮质和左侧小脑还有额外的显著减少。与健康对照相比，双相I型障碍患者的缺损仅在一个小的顶叶簇在p<0.001（未校正）时达到显著水平，而前额叶区域未达到。我们的结果表明，可能区分精神分裂症和双相情感障碍的更广泛的前额叶、丘脑和海马体缺损可能与这些疾病某些阶段单纯出现的精神病性症状无关。
