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首次发作的精神分裂症患者与首次发作的情感障碍性精神病患者及正常受试者相比,其左颞叶下部的MRI体积。

Lower left temporal lobe MRI volumes in patients with first-episode schizophrenia compared with psychotic patients with first-episode affective disorder and normal subjects.

作者信息

Hirayasu Y, Shenton M E, Salisbury D F, Dickey C C, Fischer I A, Mazzoni P, Kisler T, Arakaki H, Kwon J S, Anderson J E, Yurgelun-Todd D, Tohen M, McCarley R W

机构信息

Department of Psychiatry, Harvard Medical School, Brockton VA Medical Center, MA 02401, USA.

出版信息

Am J Psychiatry. 1998 Oct;155(10):1384-91. doi: 10.1176/ajp.155.10.1384.

Abstract

OBJECTIVE

Magnetic resonance imaging (MRI) studies of schizophrenic patients have revealed structural brain abnormalities, with low volumes of gray matter in the left posterior superior temporal gyrus and in medial temporal lobe structures. However, the specificity to schizophrenia and the roles of chronic morbidity and neuroleptic treatment in these abnormalities remain unclear.

METHOD

Magnetic resonance (1.5-T) scans were obtained from 33 patients with first-episode psychosis and 18 age-matched normal comparison subjects, all right-handed. Sixteen of the patients were diagnosed with affective disorder and 17 with schizophrenia.

RESULTS

Quantitative volumetric analysis showed that the patients with first-episode schizophrenia had significantly smaller gray matter volume in the left posterior superior temporal gyrus than did the patients with first-episode affective psychosis or the comparison subjects, with a significant left-less-than-right asymmetry. The schizophrenic patients also showed a smaller gray matter volume of the left posterior amygdala-hippocampal complex than the comparison subjects. Both the patients with schizophrenia and those with affective psychosis had significant left-less-than-right asymmetry of the posterior amygdala-hippocampal complex.

CONCLUSIONS

These findings suggest that temporal lobe abnormalities are present at the first hospitalization for schizophrenia and that low volume of the left posterior superior temporal gyrus gray matter is specific to schizophrenia compared with affective disorder.

摘要

目的

对精神分裂症患者的磁共振成像(MRI)研究揭示了大脑结构异常,左侧颞上回后部和颞叶内侧结构的灰质体积较小。然而,这些异常对精神分裂症的特异性以及慢性疾病和抗精神病药物治疗在其中的作用仍不清楚。

方法

对33例首发精神病患者和18名年龄匹配的正常对照者进行了磁共振(1.5-T)扫描,所有受试者均为右利手。其中16例患者被诊断为情感障碍,17例为精神分裂症。

结果

定量体积分析显示,首发精神分裂症患者左侧颞上回后部的灰质体积显著小于首发情感性精神病患者或对照者,且存在显著的左侧小于右侧的不对称性。精神分裂症患者左侧杏仁核-海马复合体后部的灰质体积也小于对照者。精神分裂症患者和情感性精神病患者的杏仁核-海马复合体后部均存在显著的左侧小于右侧的不对称性。

结论

这些发现表明,精神分裂症患者首次住院时就存在颞叶异常,与情感障碍相比,左侧颞上回后部灰质体积减小是精神分裂症的特异性表现。

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