Schlaepfer T E, Harris G J, Tien A Y, Peng L W, Lee S, Federman E B, Chase G A, Barta P E, Pearlson G D
Department of Psychiatry, Johns Hopkins Medical Institutions, Baltimore, MD.
Am J Psychiatry. 1994 Jun;151(6):842-8. doi: 10.1176/ajp.151.6.842.
The authors hypothesized that cortical gray matter volume reduction in schizophrenia is greatest in the heteromodal association cortex. This area comprises a highly integrated, reciprocally interconnected system that coordinates higher order cortical functions.
Total brain and regional gray matter volumes were calculated in 46 schizophrenic patients and 60 age and sex-matched comparison subjects by using magnetic resonance images. Disease specificity was examined by assessing 27 patients with bipolar disorder. Approximations to the dorsolateral prefrontal cortex, inferior parietal lobule, and superior temporal gyrus were selected as regions of interest for the heteromodal association cortex. Occipital and sensorimotor areas were used as comparison regions to test the hypothesis for regional specificity.
Gray matter volume was reduced in schizophrenic patients in index regions even after covariance for overall brain volume, sex, and age. Bipolar disorder patients did not exhibit heteromodal gray matter reduction. Comparison regions did not differ among the three groups. Global gray matter volume was not different among groups after covariance for global brain volume. Comprehensive individual region post hoc analysis found no additional gray matter differences.
These findings support the theory of disproportionate reduction of gray matter volume in the heteromodal association cortex specific to schizophrenia.
作者推测,精神分裂症患者皮质灰质体积减少在异模态联合皮质最为显著。该区域包含一个高度整合、相互连接的系统,负责协调高级皮质功能。
通过磁共振成像计算46例精神分裂症患者及60例年龄和性别匹配的对照者的全脑和区域灰质体积。通过评估27例双相情感障碍患者来检验疾病特异性。选取背外侧前额叶皮质、顶下小叶和颞上回的近似区域作为异模态联合皮质的感兴趣区。枕叶和感觉运动区作为对照区域以检验区域特异性假设。
即使在校正了全脑体积、性别和年龄后,精神分裂症患者指标区域的灰质体积仍减少。双相情感障碍患者未出现异模态灰质减少。三组之间对照区域无差异。在校正全脑体积后,三组之间的全脑灰质体积无差异。综合个体区域的事后分析未发现其他灰质差异。
这些发现支持了精神分裂症特异性的异模态联合皮质灰质体积不成比例减少的理论。