Uranova N A, Kolomeets N S, Vikhreva O V, Zimina I S, Rakhmanova V I, Orlovskaya D D
Mental Health Research Centre, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(2):104-109. doi: 10.17116/jnevro201711721104-109.
Previously the authors have reported the ultrastructural pathology of myelinated fibers (MF) in the brain in schizophrenia. The aim of the present study was to compare the effect of disease course on ultrastructural changes of MF.
Postmortem electron microscopic morphometric study of MF was performed in the prefrontal cortex, caudate nucleus and hippocampus in 19 cases of paranoid schizophrenia. Fourteen cases of continuous schizophrenia, 5 cases of attack-like schizophrenia and 25 normal matched control cases were studied. The proportion (percentage) of pathological MF was estimated in the prefrontal cortex, layer 5, CA3 area of hippocampus, pyramidal layer, and in the head of the caudate nucleus.
The percentage of MF having axonal atrophy and swelling of periaxonal oligodendrocyte process was significantly higher in both continuous and attack-like schizophrenia in all brain structures studied as compared to the control group. In the hippocampus and caudate nucleus, this parameter was increased significantly in attack-like schizophrenia as compared to continuous schizophrenia. In the prefrontal cortex. The percentage of the pathological MF having signs of deformation and destruction of myelin sheaths increased significantly only in continuous schizophrenia as compared to the control group.
MF pathology is similar in attack-like and continuous paranoid schizophrenia but differ by the degree of severity of pathological MF. Abnormalities in MF contribute to the disconnectivity between the prefrontal cortex, caudate nucleus and hippocampus.
此前作者已报道过精神分裂症患者大脑中髓鞘纤维(MF)的超微结构病理学。本研究的目的是比较病程对MF超微结构变化的影响。
对19例偏执型精神分裂症患者的前额叶皮质、尾状核和海马进行死后电子显微镜形态计量学研究。研究了14例持续性精神分裂症患者、5例发作样精神分裂症患者和25例正常对照者。估计前额叶皮质第5层、海马CA3区、锥体细胞层以及尾状核头部病理性MF的比例(百分比)。
与对照组相比,在所有研究的脑结构中,持续性和发作样精神分裂症患者中轴突萎缩和轴周少突胶质细胞突起肿胀的MF百分比均显著更高。在海马和尾状核中,与持续性精神分裂症相比,发作样精神分裂症的这一参数显著增加。在前额叶皮质,与对照组相比,仅在持续性精神分裂症中,有髓鞘变形和破坏迹象的病理性MF百分比显著增加。
发作样和持续性偏执型精神分裂症中的MF病理学相似,但病理性MF的严重程度不同。MF异常导致前额叶皮质、尾状核和海马之间的联系中断。