Reduced dorsal and orbital prefrontal gray matter volumes in schizophrenia
Reduced dorsal and orbital prefrontal gray matter volumes in schizophrenia
复制标题
DOI：
10.1001/archpsyc.57.8.761
复制
发表时间：
2000-08-01
影响因子：
--
通讯作者：
Gur, RC
中科院分区：
文献类型：
--
作者：
Gur, RE;Cowell, PE;Gur, RC
背景：神经解剖学、神经生理学和神经行为学的证据汇聚在一起，表明精神分裂症与前额叶亚区有关。利用磁共振成像进行的神经解剖学研究能够对区域体积进行划分。不一致的报告可能与方法多样和样本量小有关。我们试图在一个大样本中解决前额叶各部分的体积差异，并将体积与临床和神经认知特征相关联。
方法：对70例精神分裂症患者（40名男性和30名女性；29例未使用过抗精神病药物，41例既往接受过治疗）和81名健康对照者（34名男性和47名女性）进行磁共振成像。对背外侧、背内侧、眶外侧和眶内侧前额叶皮质的灰质和白质体积进行量化。同时对症状、功能和神经认知进行评估。
结果：在患者中观察到前额叶灰质体积减少。男性（9%）和女性（11%）的背外侧区域、仅男性的背内侧区域（9%）以及仅女性的眶区（外侧和内侧分别为23%和10%）体积减少明显。女性眶区体积的减少与病前功能较差、阴性症状更严重以及抑郁有关。在所有组中，背侧皮质体积与抽象和注意力任务的更好表现呈正相关。
结论：精神分裂症与前额叶皮质灰质体积减少有关，这在背外侧区域影响男性和女性。对于背内侧和眶区，这种影响受性别调节，并且与症状严重程度和认知功能有关。这不是治疗的副产品，因为在未使用过抗精神病药物的患者中差异也很明显。
Background: Converging neuroanatomic, neurophysiological, and neurobehavioral evidence implicate prefrontal subregions in schizophrenia. Neuroanatomic studies with magnetic resonance (MR) imaging enable regional volume parcellation. Inconsistent reports may relate to variable methods and small samples. We attempted to resolve volume differences within sectors of the prefrontal lobe in a large sample, relating volumes to clinical and neurocognitive features.Methods: Magnetic resonance imaging was performed in 70 patients with schizophrenia (40 men and 30 women; 29 neuroleptic naive and 41 previously treated) and 81 healthy controls (34 men and 47 women). Gray and white matter volumes of the dorsolateral, dorsomedial, orbitolateral, and orbitomedial prefrontal cortex were quantified. Symptoms, functioning, and neurocognition were assessed concurrently.Results: Reduced prefrontal gray matter volume was ob-served in patients. The reduction was evident for the dorsolateral al area in men (9%) and women (11%), for the dorsomedial area only in men (9%), and for orbital regions only in women (23% and 10% for lateral and medial, respectively). The reduction of orbital volume in women was associated with poorer premorbid functioning, more severe negative symptoms, and depression. Volume of dorsal cortex was positively associated with better performance on abstraction and attention tasks across all groups.Conclusions: Schizophrenia is associated with reduced gray matter volume in prefrontal cortex, which affects men and women in the dorsolateral sector. The effects are moderated by sex for dorsomedial and orbital regions and are related to symptom severity and cognitive function. This is not a by-product of treatment, since the differences are evident in neuroleptic-naive patients.