Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research (NORMENT), Oslo University Hospital, Nydalen, P.O. Box 4956, 0424, Oslo, Norway.
Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Eur Arch Psychiatry Clin Neurosci. 2020 Sep;270(6):771-782. doi: 10.1007/s00406-020-01098-y. Epub 2020 Jan 24.
Schizophrenia (SCZ) is associated with an increased risk of violence compared to the general population. Previous studies have indicated smaller hippocampal and amygdala volumes in violent than non-violent psychotic patients However, little is known about volumetric differences at the subdivision level of these structures. In the present study, hippocampal subfields and amygdala nuclei volumes were estimated with FreeSurfer from 3 T MRI of SCZ patients with (SCZ-V, n = 24) and without (SCZ-NV, n = 51) a history of severe violence and 90 healthy controls (HC). Volumetric differences between groups were explored with a general linear model covarying for confounders, in addition to follow-up analyses in patient groups controlling for clinical characteristics such as antipsychotic medication, duration of illness and illicit substance use. SCZ-V had smaller total hippocampal volume and smaller CA1, HATA, fimbria, and molecular layer of DG volumes compared to HC. Total amygdala volume together with basal nucleus, accessory basal nucleus, CTA, and paralaminar nucleus volumes were smaller in SCZ-V compared to HC. In SCZ-NV, compared to HC, the observed smaller volumes were limited to basal and paralaminar nucleus. There were no significant differences in hippocampal subfield and amygdala nuclei volumes between SCZ-V and SCZ-NV. Follow-up analyses showed that the results in patient groups were not affected by clinical characteristics. The results suggest that smaller hippocampal subfield and amygdala nuclei volumes may be relevant to violence risk in SCZ. However, the neurobiological signature of violence in SCZ should be further investigated in larger cohorts.
精神分裂症（SCZ）与一般人群相比，暴力风险增加。先前的研究表明，暴力精神病患者的海马体和杏仁核体积小于非暴力患者。然而，对于这些结构的细分水平的体积差异知之甚少。在本研究中，使用 FreeSurfer 从 3T MRI 估计 SCZ 患者（有暴力史的 SCZ-V，n=24）和无暴力史的 SCZ 患者（SCZ-NV，n=51）以及 90 名健康对照者（HC）的海马体亚区和杏仁核核体积。通过一般线性模型探索组间体积差异，协变量包括混杂因素，此外还对患者组进行了随访分析，控制了抗精神病药物、疾病持续时间和非法药物使用等临床特征。与 HC 相比，SCZ-V 的总海马体体积较小，CA1、HATA、fimbria 和 DG 分子层体积较小。与 HC 相比，SCZ-V 的总杏仁核体积以及基底核、辅助基底核、CTA 和旁层核体积较小。与 HC 相比，SCZ-NV 观察到的较小体积仅限于基底核和旁层核。在 SCZ-V 和 SCZ-NV 之间，海马体亚区和杏仁核核体积没有差异。随访分析表明，患者组的结果不受临床特征的影响。结果表明，较小的海马体亚区和杏仁核核体积可能与 SCZ 中的暴力风险相关。然而，应该在更大的队列中进一步研究 SCZ 中暴力的神经生物学特征。
