1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.
2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
Aust N Z J Psychiatry. 2017 Oct;51(10):1041-1051. doi: 10.1177/0004867417715914. Epub 2017 Jul 1.
Ventricular enlargement is common in established schizophrenia; however, data from ultra high-risk for psychosis and first-episode psychosis studies are inconclusive. This study aims to investigate ventricular volumes at different stages of psychosis.
Ventricular volumes were measured using a semi-automated and highly reliable method, for 89 established schizophrenia, 162 first-episode psychosis, 135 ultra high-risk for psychosis and 87 healthy controls using 1.5T magnetic resonance images. Clinical outcome diagnoses for ultra high-risk for psychosis were evaluated at long-term follow-up (mean: 7.5 years).
Compared to controls, we identified significant ventricular enlargement of 36.2% in established schizophrenia ( p < 0.001). Ventricular enlargement was not significant in first-episode psychosis (6%) or ultra high-risk for psychosis (-3%). Examination across stages of schizophrenia-spectrum diagnoses subgroups revealed a significant linear trend ( p = 0.006; established schizophrenia = 36.2%, first-episode psychosis schizophrenia = 18.5%, first-episode psychosis schizophreniform = -4.2% and ultra high-risk for psychosis-schizophrenia converters = -18.5%).
Ventricular enlargement is apparent in patients with established schizophrenia but is not a feature at the earliest stages of illness (ultra high-risk for psychosis and first-episode psychosis). Further research is needed to fully characterize the nature and timing of ventricular volume changes early in the course of illness and how these changes impact outcomes.
精神分裂症患者中脑室扩大较为常见，但精神病高危人群和首发精神病患者的研究数据尚无定论。本研究旨在探讨不同精神病阶段的脑室容积。
使用半自动、高度可靠的方法，对 89 例精神分裂症患者、162 例首发精神病患者、135 例精神病高危人群和 87 例健康对照者进行 1.5T 磁共振成像检查，测量脑室容积。对精神病高危人群进行长期随访（平均 7.5 年），评估临床结局诊断。
与对照组相比，我们发现精神分裂症患者的脑室扩大了 36.2%（p<0.001）。首发精神病患者（6%）或精神病高危人群（-3%）脑室无明显扩大。对精神病谱诊断亚组各阶段的检查显示出显著的线性趋势（p=0.006；精神分裂症患者的脑室扩大率为 36.2%，首发精神病患者的精神分裂症为 18.5%，首发精神病患者的分裂样障碍为-4.2%，精神病高危人群向精神分裂症转化者为-18.5%）。
在已确诊的精神分裂症患者中，脑室扩大明显，但在疾病的最早阶段（精神病高危人群和首发精神病），脑室扩大不是特征。需要进一步研究，以充分描述疾病早期脑室容积变化的性质和时间，以及这些变化如何影响结局。
