Fetal hypoxia and structural brain abnormalities in schizophrenic patients, their siblings, and controls
Fetal hypoxia and structural brain abnormalities in schizophrenic patients, their siblings, and controls
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DOI：
10.1001/archpsyc.59.1.35
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发表时间：
2002-01-01
影响因子：
--
通讯作者：
Standertskjöld-Nordenstam, CG
中科院分区：
文献类型：
--
作者：
Cannon, TD;van Erp, TGM;Standertskjöld-Nordenstam, CG
背景资料：皮质灰质减少和脑脊液（CSF）增加是精神分裂症的强相关性，但它们与产科和其他病因危险因素的关系仍有待建立。对64名精神分裂症或情感性精神分裂症患者进行了结构化的诊断访谈、产科医院记录和脑部磁共振成像扫描（代表芬兰赫尔辛基出生队列中所有此类先证者），沿着他们的51名非精神病同胞和54名无精神病家族史的人口统计学相似对照。胎儿缺氧可预测患者大脑皮质两侧灰质减少和CSF增加（灰质效应量，-0.31至-0.56; CSF效应量，0.25至0.47）和兄弟姐妹（灰质效应大小，0.33至0.47; CSF效应大小，0.17至0.33），在颞叶中最强烈。在出生时小于胎龄的病例中，效应大小是其2 - 3倍。缺氧也与心室扩大显著相关，但仅在患者中（效应值，0.31）。相反，胎儿缺氧与患者和兄弟姐妹中的白色物质无关，也与对照组中任何区域的任何组织类型无关。该协会是独立的家庭成员，整体脑容量，年龄，性别，药物滥用，产前infection.Conclusions：胎儿缺氧与更大的结构性脑异常的精神分裂症患者和他们的nonschizophrenic兄弟姐妹比控制在低遗传风险的精神分裂症。这种结果模式指出了一种基因-环境相互作用的疾病的神经发育发病机制。
Background: Cortical gray matter reductions and cerebrospinal fluid (CSF) increases are robust correlates of schizophrenia, but their relationships to obstetric and other etiologic risk factors remain to be established.Methods: Structured diagnostic interviews, obstetric hospital records, and magnetic resonance imaging scans of the brain were obtained for 64 schizophrenic or schizoaffective patients (representative of all such probands in a Helsinki, Finland, birth cohort), along with 51 of their nonpsychotic full siblings and 54 demographically similar controls without family histories of psychosis.Results: Fetal hypoxia predicted reduced gray matter and increased CSF bilaterally throughout the cortex in patients (gray matter effect sizes, -0.31 to -0.56; CSF effect sizes, 0.25 to 0.47) and siblings (gray matter effect sizes, 0.33 to 0.47; CSF effect sizes, 0.17 to 0.33), most strongly in the temporal lobe. Effect sizes were 2 to 3 times greater among cases born small for their gestational age. Hypoxia also correlated significantly with ventricular enlargement, but only among patients (effect size, 0.31). in contrast, fetal hypoxia was not related to white matter among patients and siblings, nor to any tissue type in any region among controls. The associations were independent of family membership, overall brain volume, age, sex, substance abuse, and prenatal infection.Conclusions: Fetal hypoxia is associated with greater structural brain abnormalities among schizophrenic patients and their nonschizophrenic siblings than among controls at low genetic risk for schizophrenia. This pattern of results points to a gene-environment interaction account of the disorder's neurodevelopmental pathogenesis.