Howard R, Mellers J, Petty R, Bonner D, Menon R, Almeida O, Graves M, Renshaw C, Levy R
Section of Old Age Psychiatry, Institute of Psychiatry, London.
Psychol Med. 1995 May;25(3):495-503. doi: 10.1017/s0033291700033419.
Quantified magnetic resonance measurements were made of superior temporal gyrus, parahippocampal gyrus, hippocampal, frontal and temporal lobe volumes and of the planar area of the thalamus and basal ganglia structures in 47 late paraphrenic patients and 33 healthy elderly controls. The late paraphrenics were divided into 31 schizophrenics and 16 patients with delusional disorder according to ICD-10 guidelines. Patients with delusional disorder tended to have smaller left temporal volumes compared with control subjects and patients with schizophrenia, but this difference failed to reach accepted levels of statistical significance after correction for the effects of multiple statistical comparisons, age and total brain size. Physiological right-left asymmetry, reported for temporal and frontal lobe volumes, was present in control, schizophrenic and delusional disorder subjects but delusional disorder patients had a significantly greater degree of temporal lobe asymmetry. The results add to the evidence for heterogeneity among late-onset psychoses and emphasize the subtle nature of any structural brain abnormalities in these patients.
对47例晚发性妄想症患者和33名健康老年对照者进行了定量磁共振测量，测量内容包括颞上回、海马旁回、海马、额叶和颞叶体积，以及丘脑和基底神经节结构的平面面积。根据国际疾病分类第10版（ICD - 10）指南，将晚发性妄想症患者分为31例精神分裂症患者和16例妄想障碍患者。与对照者和精神分裂症患者相比，妄想障碍患者的左侧颞叶体积往往较小，但在对多重统计比较、年龄和全脑大小的影响进行校正后，这种差异未达到公认的统计学显著性水平。在对照者、精神分裂症患者和妄想障碍患者中均存在颞叶和额叶体积的生理性左右不对称，但妄想障碍患者的颞叶不对称程度明显更大。这些结果进一步证明了晚发性精神病之间的异质性，并强调了这些患者大脑结构异常的微妙性质。
