Lim K O, Harris D, Beal M, Hoff A L, Minn K, Csernansky J G, Faustman W O, Marsh L, Sullivan E V, Pfefferbaum A
Psychiatry Service, Veterans Affairs Palo Alto Health Care System, CA 94304, USA.
Biol Psychiatry. 1996 Jul 1;40(1):4-13. doi: 10.1016/0006-3223(95)00356-8.
This study examined whether the degree of brain dysmorphology observable in adulthood was related to onset age of schizophrenic symptoms. Brain magnetic resonance imaging (MRI) scans were acquired in 57 men with schizophrenia, whose age at MRI was 19-53 years, and whose symptom onset ranged from age 7 to 29 years; all were inpatients in a state hospital. Volumes of intracranial space, cortical gray matter (GM) and white matter (WM), and cerebrospinal fluid (CSF) in lateral and third ventricles and cortical sulci were derived from MRI scans and corrected by regression analysis for variations attributable to age and head size, quantified in a control sample of healthy community volunteers. The schizophrenic patients had larger volumes of cortical and ventricular CSF and smaller volumes of cortical GM but not WM than age-matched controls, whether or not volumes were adjusted for head size and age norms. Age of onset did not correlate with any of the five age-adjusted brain measures. Neither current age, length of illness, nor symptom severity correlated with age-normalized volumes of cortical GM, sulcal CSF, or ventricular CSF. These observations are consistent with the theory that brain structure deficits 1) first develop prior to symptom onset (perhaps during the prenatal and/or early childhood process of GM development); 2) probably establish a vulnerability to subsequent dysfunctionality; but 3) are nonprogressive.
本研究探讨了成年期可观察到的脑形态异常程度是否与精神分裂症症状的起病年龄相关。对57名男性精神分裂症患者进行了脑磁共振成像（MRI）扫描，这些患者进行MRI检查时的年龄为19 - 53岁，症状起病年龄在7岁至29岁之间；他们均为一家州立医院的住院患者。通过MRI扫描得出颅内空间、皮质灰质（GM）、白质（WM）以及侧脑室、第三脑室和皮质沟中的脑脊液（CSF）体积，并通过回归分析对归因于年龄和头部大小的变化进行校正，这些变化在健康社区志愿者的对照样本中进行了量化。无论是否针对头部大小和年龄规范对体积进行调整，与年龄匹配的对照组相比，精神分裂症患者的皮质和脑室CSF体积更大，皮质GM体积更小，但WM体积无差异。起病年龄与五项年龄校正后的脑测量指标均无相关性。当前年龄、病程长短或症状严重程度与皮质GM、脑沟CSF或脑室CSF的年龄标准化体积均无相关性。这些观察结果与以下理论一致：脑结构缺陷1）首先在症状出现之前发展（可能在GM发育的产前和/或幼儿期过程中）；2）可能建立了对后续功能障碍的易感性；但3）是不进展的。
