School of Biology & Basic Medical Sciences, Medical College of Soochow University, Suzhou, 215123, China.
Department of Bioengineering, University of Pittsburgh, 3700 O'Hara Street, Pittsburgh, PA, 15261, USA.
J Psychiatr Res. 2023 Aug;164:447-453. doi: 10.1016/j.jpsychires.2023.06.036. Epub 2023 Jul 6.
Previous studies have indicated that schizophrenia is associated with an increased risk of violence, which may constitute a public health concern, leading to poor treatment outcomes and stigmatization of patients. Investigating brain structural features of violence in schizophrenia could help us understand its specific pathogenesis and find effective biomarkers. Our study aimed at identifying reliable brain structural changes associated with violence in patients with schizophrenia by conducting a meta-analysis and meta-regression of magnetic resonance imaging studies. Specific brain changes in patients with schizophrenia and violence (VSZ) were studied, compared with patients with schizophrenia and violence (VSZ), patients with non-violent schizophrenia (NVSZ), and individuals with a history of violence only and health controls. Primary outcomes revealed that there was no significant difference of gray matter volume between patients with VSZ and patient with NVSZ. Compared with controls, patients with VSZ exhibited decreased gray matter volume in the insula, the superior temporal gyrus (STG), the left inferior frontal gyrus, the left parahippocampus, and the right putamen. Compared with individuals with a history of violence only, patients with VSZ exhibited decreased volume in the right insula and the right STG. Meta-regression analysis revealed a negative correlation between the duration of schizophrenia and the volume of the right insula in patients with VSZ. These findings may suggest a shared neurobiological basis for both violence and psychiatric symptoms. The impaired frontotemporal-limbic network may serve as a neurobiological basis for higher prevalence of violent behaviour in patients with schizophrenia. However, it is important to note that these changes are not unique to patients with VSZ. Further investigation is needed to explore the neural mechanism that drive the interaction between violent behaviour and specific aggression-related dimensions of schizophrenia.
先前的研究表明，精神分裂症与暴力风险增加有关，这可能构成公共卫生关注，导致治疗效果不佳和患者受到污名化。研究精神分裂症暴力的大脑结构特征可以帮助我们了解其特定的发病机制，并找到有效的生物标志物。我们的研究旨在通过对磁共振成像研究进行荟萃分析和荟萃回归，确定与精神分裂症患者暴力行为相关的可靠大脑结构变化。研究了精神分裂症和暴力患者（VSZ）的特定大脑变化，将其与非暴力精神分裂症患者（NVSZ）和仅有暴力史和健康对照组进行比较。主要结果显示，VSZ 患者和 NVSZ 患者的灰质体积没有显著差异。与对照组相比，VSZ 患者的岛叶、颞上回（STG）、左侧额下回、左侧海马旁回和右侧壳核灰质体积减少。与仅有暴力史的个体相比，VSZ 患者的右侧岛叶和右侧 STG 体积减少。元回归分析显示，VSZ 患者中精神分裂症持续时间与右侧岛叶体积呈负相关。这些发现可能表明暴力和精神症状有共同的神经生物学基础。额叶-颞叶-边缘网络受损可能是精神分裂症患者暴力行为发生率较高的神经生物学基础。然而，需要注意的是，这些变化并非 VSZ 患者所特有。需要进一步研究探索驱动暴力行为与精神分裂症特定攻击相关维度相互作用的神经机制。
