Marsh L, Harris D, Lim K O, Beal M, Hoff A L, Minn K, Csernansky J G, DeMent S, Faustman W O, Sullivan E V, Pfefferbaum A
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Calif., USA.
Arch Gen Psychiatry. 1997 Dec;54(12):1104-12. doi: 10.1001/archpsyc.1997.01830240060009.
Early age at onset of schizophrenia often signifies a more severe form of the illness. However, the relationship between age at onset and brain abnormalities has not been established. We assessed temporal-limbic morphometry in severely ill men with chronic schizophrenia who had a relatively early onset of illness and examined the relationships among regional brain volumes, clinical symptoms, and age at illness onset.
Temporal lobe, superior temporal gyrus, hippocampus, temporal horn, lateral ventricles, third ventricle, and frontoparietal volumes were measured on magnetic resonance imaging data from 56 schizophrenic men (mean [SD] age at illness onset, 16.6 [4.2] years) recruited from a state hospital and 52 age- and range-matched healthy control men.
Patients had significantly smaller gray matter volumes in the temporal lobe, superior temporal gyrus, and frontoparietal regions; smaller temporal lobe white matter volumes; and larger cerebrospinal fluid volumes for temporal lobe sulci and the 3 ventricular measures. There were no group differences in hippocampal volumes. Psychotic symptom subscores from the Brief Psychiatric Rating Scale were selectively correlated with smaller left posterior superior temporal gyrus gray matter volumes. None of the brain measurements were significantly correlated with age at illness onset.
Data from this unique sample of severely ill schizophrenic men emphasize a pattern of structural abnormalities involving the cortex, but not the hippocampus, in schizophrenia. Furthermore, these data support theories suggesting that superior temporal gyrus abnormalities contribute selectively to psychotic symptoms and that the extent of structural abnormalities is unrelated to age of clinical symptom onset.
精神分裂症发病年龄较早通常意味着病情更为严重。然而，发病年龄与脑结构异常之间的关系尚未明确。我们评估了患有慢性精神分裂症且发病年龄相对较早的重症男性的颞叶-边缘系统形态学，并研究了脑区体积、临床症状和发病年龄之间的关系。
对从一家州立医院招募的56名精神分裂症男性（发病时平均[标准差]年龄为16.6[4.2]岁）和52名年龄及范围匹配的健康对照男性的磁共振成像数据测量颞叶、颞上回、海马体、颞角、侧脑室、第三脑室以及额顶叶体积。
患者的颞叶、颞上回和额顶叶区域灰质体积显著减小；颞叶白质体积减小；颞叶沟及三个脑室测量指标的脑脊液体积增大。海马体体积在两组间无差异。简明精神病评定量表的精神病性症状子评分与左侧后颞上回灰质体积减小选择性相关。脑测量指标均与发病年龄无显著相关性。
来自这一独特的重症精神分裂症男性样本的数据强调了精神分裂症中涉及皮质而非海马体的结构异常模式。此外，这些数据支持了以下理论，即颞上回异常选择性地导致精神病性症状，且结构异常程度与临床症状发病年龄无关。
