Follow-up MRI study of prefrontal volumes in first-episode psychotic patients
Follow-up MRI study of prefrontal volumes in first-episode psychotic patients
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DOI：
10.1016/j.schres.2004.04.010
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发表时间：
2004-12-01
影响因子：
4.5
通讯作者：
Shenton, ME
中科院分区：
文献类型：
--
作者：
Dickey, CC;Salisbury, DF;Shenton, ME
精神分裂症和情感障碍中前额叶皮质异常的结构性 MRI 结果不一致，可能是由于样本量小、异质性、前额叶灰质和白质的综合评估以及前额叶皮质通常不划分为单独的脑回这一事实（例如，Shenton 等人，2001 年；Strakowski 等人，2002 年）。我们之前报道过，相对于首发情感性精神病和对照组，首发精神分裂症患者的前额叶灰质较小（Hirayasu et al., 2001）。文献中一个未解决的问题是随着时间的推移是否会观察到体积进一步减少，这是本报告的重点。在第一次住院时测量了精神分裂症患者（n = 12，3 名女性）或情感性精神病（n = 10，1 名女性，9 名双相，1 名单相）和精神状况良好的受试者（n = 15， 1 女）。大约 1.5 年后对受试者进行了重新扫描。先前仅在第一次扫描时描述了七名精神分裂症患者、六名情感患者和四名对照受试者（Hirayasu 等，2001）。样本在年龄 (28.1±8.4; 22.9±2.8; 25.4±4.5; F (2, 34)= 2.2, p= 0.12) 或 WAIS 信息分数 (11.8±3.4; 12.2±3.1, 11.8±2.0; F (2.32)= 0.6, p= 0.9) 上没有差异，父母的社会经济地位（F（2.34）= 2.32， p= 0.11) 或用手习惯 (F (2.33)= 1.6, p= 0.22)。精神分裂症患者的BPRS评分（41.2±13.2）高于情感患者的BPRS评分（33.8±8.0）（F（1, 20）= 5.71，p= 0.027）。为患者组开出类似的精神安定药（精神分裂症：7 名典型患者，4 名非典型患者，1 名无患者；情感患者：6 名典型患者，3 名非典型患者，1 名无患者）。
Structural MRI findings of abnormalities in the prefrontal cortex in schizophrenia and affective disorder have been inconsistent likely due to small, heterogeneous samples, the evaluation of prefrontal gray and white matter combined, and the fact that prefrontal cortex is typically not delineated into separate gyri (eg, Shenton et al., 2001; Strakowski et al., 2002). We previously reported smaller prefrontal gray matter in first-episode schizophrenia relative to first-episode affective psychosis and controls (Hirayasu et al., 2001). One unresolved question in the literature is whether or not further volume reduction will be observed over time, the focus of this report.Prefrontal gray and white matter volumes were measured (see Fig. 1) in patients at the time of first hospitalization for schizophrenia (n= 12, 3 females) or affective psychosis (n= 10, 1 female, 9 bipolar, 1 unipolar), and psychiatrically well subjects (n= 15, 1 female). Subjects were rescanned approximately 1.5 years later. Seven schizophrenia, six affective, and four comparison subjects were previously described solely at first scan (Hirayasu et al., 2001). Samples did not differ in age (28.1±8.4; 22.9±2.8; 25.4±4.5; F (2, 34)= 2.2, p= 0.12) or WAIS Information scores (11.8±3.4; 12.2±3.1, 11.8±2.0; F (2.32)= 0.6, p= 0.9), nor in parental socioeconomic status (F (2.34)= 2.32, p= 0.11) or handedness (F (2.33)= 1.6, p= 0.22). BPRS scores were higher in schizophrenics (41.2±13.2) than affectives (33.8±8.0)(F (1, 20)= 5.71, p= 0.027). Similar neuroleptics were prescribed for the patient groups (schizophrenics: 7 typical, 4 atypical, 1 none; affectives: 6 typical, 3 atypical, 1 none).