A follow-up MRI study of the superior temporal subregions in schizotypal disorder and first-episode schizophrenia
A follow-up MRI study of the superior temporal subregions in schizotypal disorder and first-episode schizophrenia
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DOI：
10.1016/j.schres.2009.12.006
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发表时间：
2010-06
影响因子：
4.5
通讯作者：
Tsutomu Takahashi;Michio Suzuki;Shi-Yu Zhou;R. Tanino;Kazue Nakamura;Y. Kawasaki;H. Seto;M. Kurachi
中科院分区：
文献类型：
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作者：
Tsutomu Takahashi;Michio Suzuki;Shi-Yu Zhou;R. Tanino;Kazue Nakamura;Y. Kawasaki;H. Seto;M. Kurachi
虽然纵向磁共振成像（MRI）研究表明，在精神分裂症的早期阶段，颞上回（STG）的灰质会逐渐减少，但仍不清楚具有分裂型特征的患者是否也表现出类似的STG变化。在这项研究中，纵向MRI数据来自18名首发精神分裂症患者，13名分裂型障碍患者和20名健康对照。在基线和随访（平均2.7年）扫描中测量STG及其亚区域[极平面（PP）、颞平面（HG）、吻侧STG和尾侧STG]的体积，并比较各组间的差异。在基线时，精神分裂症和分裂型患者的左侧PT和左侧尾侧STG均小于对照组。在纵向比较中，与分裂型患者（左：−0.6%/年，右：−0.3%/年）和对照组（左：0.0%/年，右：−0.1%/年）相比，精神分裂症患者的STG灰质随着时间的推移而显著减少（左：−2.8%/年，右：−1.5%/年），而抗精神病药物的分区域或类型（典型/非典型）没有明显的影响。在精神分裂症患者中，左侧PP和右侧PT的年体积减少与阳性精神病症状的改善较少相关。在精神分裂症患者随访期间，较高的抗精神病药物累积剂量与较轻的左侧PT和双侧尾侧STG灰质减少显著相关。我们的研究结果表明，在精神分裂症谱系疾病中，左侧后STG亚区通常减少；然而，精神分裂症患者在疾病早期表现出与明显精神病相关的进一步进行性STG变化。
While longitudinal magnetic resonance imaging (MRI) studies have demonstrated progressive gray matter reduction of the superior temporal gyrus (STG) during the early phases of schizophrenia, it remains unknown whether patients with schizotypal features exhibit similar STG changes. In this study, longitudinal MRI data were obtained from 18 patients with first-episode schizophrenia, 13 patients with schizotypal disorder, and 20 healthy controls. The volumes of the STG and its subregions [planum polare (PP), Heschl gyrus (HG), planum temporale (PT), rostral STG, and caudal STG] were measured on baseline and follow-up (mean: 2.7years) scans and were compared across groups. At the baseline, both the schizophrenia and schizotypal patients had smaller left PT and left caudal STG than the controls. In a longitudinal comparison, the schizophrenia patients showed significant gray matter reduction of the STG over time (left: −2.8%/year; right: −1.5%/year) compared with the schizotypal patients (left: −0.6%/year; right: −0.3%/year) and controls (left: 0.0%/year; right: −0.1%/year) without a prominent effect of subregion or type of antipsychotic (typical/atypical). In the schizophrenia patients, greater annual volume reductions of the left PP and right PT were correlated with less improvement of positive psychotic symptoms. A higher cumulative dose of antipsychotics during follow-up in schizophrenia was significantly correlated with less severe gray matter reductions in the left PT and bilateral caudal STG. Our findings suggest that the left posterior STG subregions are commonly reduced in diseases of the schizophrenia spectrum; whereas, schizophrenia patients exhibit further progressive STG changes associated with overt psychosis in the early years of the illness.