Progressive lateral ventricular enlargement in schizophrenia: A meta-analysis of longitudinal MRI studies
Progressive lateral ventricular enlargement in schizophrenia: A meta-analysis of longitudinal MRI studies
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DOI：
10.1016/j.schres.2010.03.036
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发表时间：
2010-07-01
影响因子：
4.5
通讯作者：
DeLisi, Lynn E.
中科院分区：
文献类型：
--
作者：
Kempton, Matthew J.;Stahl, Daniel;DeLisi, Lynn E.
背景：侧脑室增大是精神分裂症患者最一致的发现之一；然而，在病程中是否发生进行性心室扩张一直存在争议。为了澄清这一点，我们对精神分裂症患者和对照组的侧脑室进行了纵向研究的荟萃分析。方法：检索MEDLINE数据库1980 - 2009年间精神分裂症患者的纵向MRI研究。我们确定了13项研究，测量了患者和对照组的侧脑室，这些研究被纳入随机效应荟萃分析。在meta回归分析中研究了各种临床变量的影响。结果：患者发病后进行性心室增大的证据大于对照组（效应值= 0.45,95%CI 0.19-0.71, p = 0.0006）。基线扫描时平均病程为7.6年的慢性精神分裂症患者的亚分析也显示进行性心室增大（p = 0.002）。结果符合纳入标准，在meta回归分析中没有发现发病年龄、病程或基线扫描年龄的显著影响。结论：荟萃分析显示，发病数年后脑室容积进行性变化，挑战了精神分裂症的神经发育模型。(C) 2010 Elsevier B.V.版权所有
Background: Lateral ventricular enlargement is one of the most consistent findings in patients with schizophrenia; however whether progressive ventricular dilation occurs during the course of the illness has been controversial. To clarify this we conducted a meta-analysis of longitudinal studies measuring the lateral ventricles in patients with schizophrenia and a control group.Methods: The MEDLINE database was searched from 1980 to 2009 for longitudinal MRI studies of patients with schizophrenia. We identified 13 studies that measured the lateral ventricles in both patients and controls and these were included in a random effects meta-analysis. The effect of various clinical variables was investigated in a meta-regression analysis.Results: Patients showed evidence of progressive ventricular enlargement after illness onset greater than that seen in controls (effect size = 0.45, 95%CI 0.19-0.71, p = 0.0006). A sub-analysis of chronic patients with schizophrenia with a mean duration of illness of 7.6 years at baseline scan also showed progressive ventricular enlargement (p = 0.002). The results were robust to inclusion criteria, and no significant effect of age of onset, duration of illness, or age at baseline scan, was found in the meta-regression analysis.Conclusions: The meta-analysis shows progressive changes in ventricular volume a number of years after illness onset and challenges an exclusively neurodevelopmental model of schizophrenia. (C) 2010 Elsevier B.V. All rights reserved.