Buchanan R W, Breier A, Kirkpatrick B, Elkashef A, Munson R C, Gellad F, Carpenter W T
Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore 21228.
Am J Psychiatry. 1993 Jan;150(1):59-65. doi: 10.1176/ajp.150.1.59.
Previous studies have suggested the involvement of the frontal and parietal cortices and thalamus in a neural circuit underlying the production of primary enduring negative or deficit symptoms of schizophrenia. The purpose of this study was to examine whether structural changes in the proposed circuit are associated with the production of deficit symptoms.
Magnetic resonance imaging was used to measure the volume of selected circuit brain regions (i.e., the prefrontal region and caudate) and noncircuit brain regions (i.e., the amygdala/hippocampus complex) in 17 deficit and 24 nondeficit schizophrenic outpatients and 30 normal comparison subjects.
Right and left total prefrontal volumes discriminated deficit from nondeficit patients, with prefrontal volumes being smaller in nondeficit patients. There were no differences between the two schizophrenic subgroups in left caudate or right and left amygdala/hippocampus complex volumes. The right caudate was larger in deficit patients, but the difference between the two schizophrenic subgroups was not significant. There were no differences between deficit and normal subjects on any prefrontal region measure. Nondeficit patients had smaller total right and left prefrontal volumes than normal subjects. Both schizophrenic subgroups had larger left caudate volumes and smaller right and left amygdala/hippocampus complex volumes than the normal subjects. There was a trend for deficit patients to have larger right caudate volumes.
These results suggest that structural changes in the prefrontal region are not responsible for deficit symptoms. The caudate, particularly the right caudate, may be associated with the production of these symptoms.
先前的研究表明，额叶和顶叶皮质以及丘脑参与了精神分裂症原发性持续性阴性或缺陷症状产生的神经回路。本研究的目的是检验该假定回路中的结构变化是否与缺陷症状的产生有关。
采用磁共振成像测量17例有缺陷症状和24例无缺陷症状的精神分裂症门诊患者以及30名正常对照者的选定回路脑区（即前额叶区域和尾状核）和非回路脑区（即杏仁核/海马复合体）的体积。
左右前额叶总体积可区分有缺陷症状和无缺陷症状的患者，无缺陷症状患者的前额叶体积较小。两个精神分裂症亚组在左侧尾状核或右侧及左侧杏仁核/海马复合体体积上没有差异。有缺陷症状患者的右侧尾状核较大，但两个精神分裂症亚组之间的差异不显著。在任何前额叶区域测量指标上，有缺陷症状患者与正常受试者之间均无差异。无缺陷症状患者的左右前额叶总体积比正常受试者小。两个精神分裂症亚组的左侧尾状核体积均比正常受试者大，右侧及左侧杏仁核/海马复合体体积均比正常受试者小。有缺陷症状患者的右侧尾状核体积有增大的趋势。
这些结果表明，前额叶区域的结构变化与缺陷症状无关。尾状核，尤其是右侧尾状核，可能与这些症状的产生有关。
