Common pattern of cortical pathology in childhood-onset and adult-onset schizophrenia as identified by proton magnetic resonance spectroscopic imaging
Common pattern of cortical pathology in childhood-onset and adult-onset schizophrenia as identified by proton magnetic resonance spectroscopic imaging
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DOI：
10.1176/ajp.155.10.1376
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发表时间：
1998-10-01
影响因子：
17.7
通讯作者：
Weinberger, DR
中科院分区：
文献类型：
--
作者：
Bertolino, A;Kumra, S;Weinberger, DR
目的：多层质子磁共振光谱成像（H-1-MRSI）允许同时采集和映射的信号强度的N-乙酰基含化合物（主要是N-乙酰天冬氨酸，NAA），胆碱含化合物（CHO），肌酸加磷酸肌酸（CRE）从多个全脑切片组成的小的单体积元素。以前的H-1-MRSI研究显示，与健康受试者相比，在海马区和背外侧前额叶皮质小NAA相关信号的成年精神分裂症患者。作为解决儿童期发作和成人期发作精神分裂症之间病理生理连续性的计划的一部分，作者对儿童期发作精神分裂症患者进行了H-1-MRSI，以专门测试海马区和背外侧前额叶皮质是否显示出与成人期发作精神分裂症相同的异常。方法：采用1.5T核磁共振仪对14例患者（平均年龄16.4岁）和14例对照者进行检测。测定质子谱的代谢物峰下的面积比（即，NAA/CRE、NAA/CHO、CHO/CRE）。结果如下：与对照组相比，患者双侧海马区和背外侧前额叶皮质的NAA/CRE比值显著降低。在任何其他取样地区，CHO/CRE或NAA比率均无显著差异。结论：目前的研究表明，儿童期发作的精神分裂症患者有小于正常的区域NAA的相对信号，这表明在海马区和背外侧前额叶皮质的神经元损伤或功能障碍。这些差异的幅度与成人发作的精神分裂症患者相似。目前的数据扩展了儿童和成人发作的精神分裂症之间的生物连续性的其他证据。
Objective: Multislice proton magnetic resonance spectroscopic imaging (H-1-MRSI) permits simultaneous acquisition and mapping of signal intensities of N-acetyl-containing compounds (mainly N-acetylaspartate, NAA), choline-containing compounds (CHO), and creatine plus phosphocreatine (CRE) from multiple whole-brain slices consisting of small single-volume elements. Previous H-1-MRSI studies of adult patients with schizophrenia showed small NAA relative signals in the hippocampal area and in the dorsolateral prefrontal cortex in comparison with healthy subjects. As part of a program to address the pathophysiological continuity between childhood-onset and adult-onset schizophrenia, the authors performed H-1-MRSI of patients with childhood-onset schizophrenia to specifically test whether the hippocampal area and dorsolateral prefrontal cortex show the same abnormalities as seen in adult-onset schizophrenia. Method: A 1.5-T nuclear magnetic resonance machine was used to test 14 patients (mean age, 16.4 years) and 14 comparison subjects. Ratios of areas under the metabolite peaks of the proton spectra were determined (i,e., NAA/CRE, NAA/CHO, CHO/CRE) for multiple cortical and subcortical regions. Results: The patients showed significantly lower NAA/CRE ratios bilaterally in the hippocampal area and the dorsolateral prefrontal cortex than the comparison subjects. There were no significant differences in CHO/CRE or in NAA ratios in any other area sampled. Conclusions: The present study shows that patients with childhood-onset schizophrenia have smaller than normal regional NAA relative signals, suggesting neuronal damage or malfunction in the hippocampal area and dorsolateral prefrontal cortex. These differences were similar in magnitude to those found in patients with adult-onset schizophrenia. The present data extend other evidence of a biological continuum between childhood- and adult-onset schizophrenia.