Voxel-based magnetic resonance imaging investigation of poor and preserved clinical insight in people with schizophrenia.
Voxel-based magnetic resonance imaging investigation of poor and preserved clinical insight in people with schizophrenia.
复制标题
DOI：
10.5498/wjp.v6.i3.311
复制
发表时间：
2016-09-22
影响因子：
3.1
通讯作者：
Kumari V
中科院分区：
文献类型：
--
作者：
Sapara A;Ffytche DH;Cooke MA;Williams SC;Kumari V
目的：确定精神分裂症患者的区域性灰质异常，并与患者的临床洞察力（洞察力+）和健康对照组进行比较。40例稳定期精神分裂症门诊患者（20例Insight-和20例Insight+）和20例健康对照者进行了全脑磁共振成像（MRI）。所有患者的洞察力使用Birchwood洞察力量表（BIS;自我报告测量）进行评估。这两组患者被预先选择，以匹配大多数临床和人口统计学参数，但通过设计，他们有明显不同的BIS评分。SPM 8中采用的基于体素的形态测量法用于检查整个大脑中灰质体积的组差异。三个参与者组的年龄相当[F（2，57）= 0.34，P = 0.71]，患者组的发病年龄无差异[t（38）= 0.87，P = 0.39]。Insight-和Insight+患者组在阳性和阴性症状量表（PANSS）上的症状也没有差异：阳性症状[t（38）= 0.58，P = 0.57]，阴性症状[t（38）= 0.61，P = 0.55]，一般精神病理学[t（38）= 1.30，P = 0.20]和PANSS总分[t（38）= 0.21，P = 0.84]。正如预期的那样，两组患者在BIS评估的自知力水平上存在显著差异[t（38）= 12.11，P < 0.001]。MRI结果显示，与Insight+患者和健康对照组相比，Insight-患者的额颞、海马旁、枕叶和小脑灰质体积较低（对于所有聚类，家族误差校正P < 0.05）。Insight+患者和健康对照组之间无显著差异（P > 0.20）。我们的研究结果表明，在长期稳定的精神分裂症患者中，临床洞察力差与额颞叶、枕叶和小脑灰质体积较小之间存在明显的相关性。
To define regional grey-matter abnormalities in schizophrenia patients with poor insight (Insight-), relative to patients with preserved clinical insight (Insight+), and healthy controls. Forty stable schizophrenia outpatients (20 Insight- and 20 Insight+) and 20 healthy controls underwent whole brain magnetic resonance imaging (MRI). Insight in all patients was assessed using the Birchwood Insight Scale (BIS; a self-report measure). The two patient groups were pre-selected to match on most clinical and demographic parameters but, by design, they had markedly distinct BIS scores. Voxel-based morphometry employed in SPM8 was used to examine group differences in grey matter volumes across the whole brain. The three participant groups were comparable in age [F(2,57) = 0.34, P = 0.71] and the patient groups did not differ in age at illness onset [t(38) = 0.87, P = 0.39]. Insight- and Insight+ patient groups also did not differ in symptoms on the Positive and Negative Syndromes scale (PANSS): Positive symptoms [t(38) = 0.58, P = 0.57], negative symptoms [t(38) = 0.61, P = 0.55], general psychopathology [t(38) = 1.30, P = 0.20] and total PANSS scores [t(38) = 0.21, P = 0.84]. The two patient groups, as expected, varied significantly in the level of BIS-assessed insight [t(38) = 12.11, P < 0.001]. MRI results revealed lower fronto-temporal, parahippocampal, occipital and cerebellar grey matter volumes in Insight- patients, relative to Insight+ patients and healthy controls (for all clusters, family-wise error corrected P < 0.05). Insight+ patient and healthy controls did not differ significantly (P > 0.20) from each other. Our findings demonstrate a clear association between poor clinical insight and smaller fronto-temporal, occipital and cerebellar grey matter volumes in stable long-term schizophrenia patients.