Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America.
Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America.
Schizophr Res. 2020 Aug;222:397-410. doi: 10.1016/j.schres.2020.03.073. Epub 2020 May 31.
This cross-sectional study examines the differences in cortical volume and gray-to-white matter contrast (GWC) in first episode schizophrenia patients (SCZ) compared to healthy control participants (HC) and in SCZ patients as a function of exposure to second generation antipsychotic medication. We hypothesize 1) SCZ exhibit regionally lower cortical volumes relative to HCs, 2) cortical volume will be greater with longer exposure to second generation antipsychotics prior to the MRI scan, and 3) lower GWC with longer exposure to second generation antipsychotics prior to the MRI scan, suggesting more blurring from greater intracortical myelin. To accomplish this, MRI scans from 71 male SCZ patients treated with second generation oral risperidone and 42 male HCs were examined. 3D T1-weighted MPRAGE images collected at 1.5T were used to estimate cortical volume and GWC by sampling signal intensity at 30% within the cortical ribbon. Average cortical volume and GWC were calculated and compared between SCZ and HC. Cortical volume and GWC in SCZ patients were correlated with duration of medication exposure for the time period prior to the scan. First-episode SCZ patients had significantly lower cortical volume compared to HCs in bilateral temporal, superior and rostral frontal, postcentral gyral, and parahippocampal regions. In SCZ patients, greater cortical volume was associated with (log-transformed) duration of second-generation antipsychotic medication exposure in bilateral precuneus, right lingual, and right superior parietal regions. Lower GWC was correlated with longer duration of medication exposure bilaterally in the superior frontal lobes. In summary, second generation antipsychotics may increase cortical volume and decrease GWC in first episode SCZ patients.
这项横断面研究考察了首发精神分裂症患者（SCZ）与健康对照参与者（HC）之间皮质体积和灰白质对比度（GWC）的差异，以及 SCZ 患者与第二代抗精神病药物暴露之间的差异。我们假设 1）SCZ 患者相对于 HC 表现出区域性皮质体积降低，2）在 MRI 扫描前接受第二代抗精神病药物治疗时间较长的患者皮质体积更大，3）在 MRI 扫描前接受第二代抗精神病药物治疗时间较长的患者 GWC 更低，这表明更多的皮质内髓鞘导致更模糊。为了实现这一目标，我们检查了 71 名接受第二代口服利培酮治疗的男性 SCZ 患者和 42 名男性 HC 的 MRI 扫描。使用 1.5T 采集的 3D T1 加权 MPRAGE 图像来估计皮质体积和 GWC，方法是在皮质带内以 30%的信号强度进行采样。在 SCZ 和 HC 之间比较平均皮质体积和 GWC。SCZ 患者的皮质体积和 GWC 与扫描前药物暴露时间的长短相关。首发精神分裂症患者双侧颞叶、额上和额前、中央后回和海马旁回的皮质体积明显低于 HC。在 SCZ 患者中，双侧楔前叶、右侧舌回和右侧顶上叶的皮质体积与（对数转换）第二代抗精神病药物暴露时间呈正相关。GWC 越低，双侧额上叶的药物暴露时间越长。总之，第二代抗精神病药物可能会增加首发精神分裂症患者的皮质体积并降低 GWC。
