Chakos M H, Lieberman J A, Bilder R M, Borenstein M, Lerner G, Bogerts B, Wu H, Kinon B, Ashtari M
Department of Psychiatry, Hillside Hospital-Long Island Jewish Medical Center, NY 11004.
Am J Psychiatry. 1994 Oct;151(10):1430-6. doi: 10.1176/ajp.151.10.1430.
This study examined the pathomorphology of the caudate nuclei in first-episode schizophrenic patients with minimal previous neuroleptic exposure.
Magnetic resonance imaging (MRI) of the brain was used to examine longitudinally the caudate pathomorphology in 29 first-episode schizophrenic patients and 10 healthy comparison subjects. MRI scans were obtained after the subjects entered the study and at 18-month follow-up. The patients were treated with standardized neuroleptic regimens during the 18-month period. Volumetric assessments of the cerebral cortex, lateral ventricles, and caudate nuclei were performed on T1-weighted coronal brain sections. In addition, the patients were systematically evaluated for psychopathology at baseline and during treatment.
Caudate volumes increased 5.7% in the patients during the 18-month treatment interval, whereas they decreased 1.6% in the comparison subjects over the same time period. Greater amounts of antipsychotic medication received by patients before the first scan and younger age at the time of the first scan were associated with larger increases in caudate volume.
Caudate enlargement occurs early in the course of treatment in young first-episode schizophrenic patients. This may be a result of an interaction between neuroleptic treatment and the plasticity of dopaminergic neuronal systems in young patients.
本研究探讨首次发作且之前极少使用抗精神病药物的精神分裂症患者尾状核的病理形态学。
采用脑部磁共振成像（MRI）对29例首次发作的精神分裂症患者和10名健康对照者的尾状核病理形态进行纵向检查。在受试者进入研究时及18个月随访时进行MRI扫描。在这18个月期间，患者接受标准化抗精神病药物治疗方案。对T1加权冠状脑切片进行大脑皮质、侧脑室和尾状核的体积评估。此外，在基线和治疗期间对患者的精神病理学进行系统评估。
在18个月的治疗期间，患者的尾状核体积增加了5.7%，而在同一时期，对照者的尾状核体积减少了1.6%。首次扫描前患者接受的抗精神病药物剂量越大以及首次扫描时年龄越小，尾状核体积增加越大。
年轻的首次发作精神分裂症患者在治疗早期出现尾状核增大。这可能是抗精神病药物治疗与年轻患者多巴胺能神经元系统可塑性之间相互作用的结果。
