Pfefferbaum A, Marsh L
Psychiatry Service, Department of Veterans Affairs Medical Center, Palo Alto, CA 94304, USA.
Clin Neurosci. 1995;3(2):105-11.
In vivo neuroimaging techniques have characterized the global features of brain dysmorphology in schizophrenia. These features include ventriculomegaly and widespread sulcal dilation, which particularly affect the frontal and temporal lobes and involve cortical gray matter rather than white matter. Dysmorphology of specific brain structures such as the basal ganglia and hippocampus, which have been implicated in the pathophysiology of schizophrenia by pharmacological manipulations and post mortem investigations, have not been consistently observed in vivo, perhaps because of differences in imaging and analysis techniques, methods used to control for variance due to age and head size, and sample characteristics. The epidemiology of the observed widespread brain dysmorphology supports a developmental origin, perhaps with limited progressive change beyond that expected in normal aging. Establishing the clinical significance of relatively static structural brain dysmorphologies remains a major challenge that may be best met by use of combined cross-sectional and longitudinal study designs.
体内神经成像技术已描绘出精神分裂症患者大脑畸形的整体特征。这些特征包括脑室扩大和广泛的脑沟扩张，尤其影响额叶和颞叶，且涉及皮质灰质而非白质。通过药理学操作和尸检研究已表明基底神经节和海马体等特定脑结构的畸形与精神分裂症的病理生理学有关，但在体内研究中尚未始终观察到这种畸形，这可能是由于成像和分析技术、用于控制年龄和头部大小差异的方法以及样本特征存在差异。所观察到的广泛脑畸形的流行病学支持其发育起源，可能除了正常衰老预期的有限渐进性变化外，变化不大。确定相对静态的结构性脑畸形的临床意义仍然是一项重大挑战，采用横断面和纵向研究相结合的设计可能是应对这一挑战的最佳方法。
