Lawrie S M, Abukmeil S S
Department of Psychiatry, Royal Edinburgh Hospital, Scotland.
Br J Psychiatry. 1998 Feb;172:110-20. doi: 10.1192/bjp.172.2.110.
Numerous in vivo brain imaging studies suggest that cerebral structure is abnormal in schizophrenia, but implicate different regions to varying extents.
We identified published MRI studies in schizophrenia with searches of the computerised literature and key journals. Reports giving the volumes of cortical structures in people with schizophrenia and controls were included. The percentage differences in volumes were calculated and the median taken as a summary measure for each brain region.
Forty relevant studies were identified. The median percentage volume differences revealed overall reductions in the whole brain (3%), temporal lobe (6% left, 9.5% right), and the amygdala/ hippocampal complex (6.5%, 5.5%); and increases in the lateral ventricles (44%, 36%), that were greatest in the body and occipital horns. Segmentation studies suggest that grey matter is reduced but that white matter volumes may actually be increased. In men, substantial reductions were also evident in the amygdala and hippocampus, as well as the largest reductions of all in the parahippocampus (14%, 9%). Few studies gave figures for women alone.
Several brain structures in schizophrenia are affected to a greater extent than expected from overall reductions in brain volume. Further studies are required in affected women, and to try to identify clinical and aetiological associations of these findings.
大量的活体脑成像研究表明，精神分裂症患者的脑结构存在异常，但不同程度地涉及不同区域。
我们通过检索计算机文献和主要期刊，确定了已发表的关于精神分裂症的MRI研究。纳入了报告精神分裂症患者和对照组皮质结构体积的研究。计算体积的百分比差异，并将中位数作为每个脑区的汇总指标。
共确定了40项相关研究。体积百分比差异的中位数显示，全脑（3%）、颞叶（左侧6%，右侧9.5%）以及杏仁核/海马复合体（6.5%，5.5%）总体上有所减少；侧脑室（44%，36%）增大，在体部和枕角最为明显。分割研究表明灰质减少，但白质体积实际上可能增加。在男性中，杏仁核和海马也有明显减少，海马旁回减少最为显著（14%，9%）。很少有研究单独给出女性的数据。
精神分裂症患者的几个脑结构受到的影响程度比因脑体积总体减少所预期的更大。需要对受影响的女性进行进一步研究，并试图确定这些发现的临床和病因学关联。
