The anatomy of first-episode and chronic schizophrenia: An anatomical likelihood estimation meta-analysis
The anatomy of first-episode and chronic schizophrenia: An anatomical likelihood estimation meta-analysis
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DOI：
10.1176/appi.ajp.2008.07101562
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发表时间：
2008-08-01
影响因子：
17.7
通讯作者：
Bullmore, Edward T.
中科院分区：
文献类型：
--
作者：
Ellison-Wright, Ian;Glahn, David C.;Bullmore, Edward T.
目的：作者试图绘制首发精神分裂症的灰质变化图，并将其与慢性精神分裂症的变化进行比较。他们推测，这些数据将显示从首发精神分裂症的海马缺陷到慢性精神分裂症的杏仁核和皮质灰质体积减少的一系列变化。 方法：对首发精神分裂症和慢性精神分裂症患者与对照组进行基于体素的结构 MRI 研究进行系统搜索。使用解剖似然估计对灰质差异坐标进行荟萃分析。构建了灰质变化图，并使用减法荟萃分析对其进行比较。结果：总共有 27 篇文章被确定纳入荟萃分析。在首发精神分裂症和慢性精神分裂症影响的区域中观察到显着的对应关系，包括丘脑、左钩/杏仁核区域、双侧岛叶和前扣带回的灰质减少。在首发精神分裂症和慢性精神分裂症的比较中，首发精神分裂症的双侧尾状脑灰质体积减少，但慢性精神分裂症的灰质体积没有减少；慢性精神分裂症的皮质区域减少更为普遍。结论：首发精神分裂症的解剖学变化与基底节-丘脑皮质回路大致一致。这些变化包括双侧尾状头灰质减少，而慢性精神分裂症则不存在这种情况。比较首发精神分裂症和慢性精神分裂症，作者没有找到从海马到杏仁核的颞边缘病理进展的证据，但有皮质变化进展的证据。
Objective: The authors sought to map gray matter changes in first-episode schizophrenia and to compare these with the changes in chronic schizophrenia. They postulated that the data would show a progression of changes from hippocampal deficits in first-episode schizophrenia to include volume reductions in the amygdala and cortical gray matter in chronic schizophrenia.Method: A systematic search was conducted for voxel-based structural MRI studies of patients with first-episode schizophrenia and chronic schizophrenia in relation to comparison groups. Meta-analyses of the coordinates of gray matter differences were carried out using anatomical likelihood estimation. Maps of gray matter changes were constructed, and subtraction meta-analysis was used to compare them.Results: A total of 27 articles were identified for inclusion in the meta-analyses. A marked correspondence was observed in regions affected by both first-episode schizophrenia and chronic schizophrenia, including gray matter decreases in the thalamus, the left uncus/amygdala region, the insula bilaterally, and the anterior cingulate. In the comparison of first-episode schizophrenia and chronic schizophrenia, decreases in gray matter volume were detected in first-episode schizophrenia but not in chronic schizophrenia in the caudate head bilaterally; decreases were more widespread in cortical regions in chronic schizophrenia.Conclusions: Anatomical changes in first-episode schizophrenia broadly coincide with a basal ganglia-thalamocortical circuit. These changes include bilateral reductions in caudate head gray matter, which are absent in chronic schizophrenia. Comparing first-episode schizophrenia and chronic schizophrenia, the authors did not find evidence for the temporolimbic progression of pathology from hippocampus to amygdala, but there was evidence for progression of cortical changes.