Subcortical MRI volumes in neuroleptic-naive and treated patients with schizophrenia
Subcortical MRI volumes in neuroleptic-naive and treated patients with schizophrenia
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DOI：
10.1176/ajp.155.12.1711
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发表时间：
1998-12-01
影响因子：
17.7
通讯作者：
Gur, RC
中科院分区：
文献类型：
--
作者：
Gur, RE;Maany, V;Gur, RC
目的：本研究旨在探讨精神分裂症患者基底神经节和丘脑皮质下体积是否与抗精神病药物暴露和症状严重程度相关。方法：应用磁共振成像技术测量了96例精神分裂症患者（男50例，女46例）和128例健康对照者（男60例，女68例）的基底节亚结构和丘脑体积。21例患者未接受过抗精神病药物治疗;在75例既往接受过治疗的患者中，48例仅接受过典型的抗精神病药物治疗，27例接受过典型和非典型的抗精神病药物治疗。研究了容量测量与治疗状态、抗精神病药物暴露和症状的关系。结果：除下丘脑体积外，未接受过抗精神病药物治疗的患者与健康对照受试者在皮质下体积方面没有差异。在未使用过抗精神病药物的组中，体积与阴性症状的严重程度无关，但丘脑和壳核的体积越大，阳性症状越严重。先前治疗组的壳核和苍白球体积高于健康对照组和未接受过抗精神病药物治疗的患者。在治疗组中，较高剂量的典型精神抑制剂与较高的尾状核、壳核和丘脑体积相关，而较高剂量的非典型精神抑制剂仅与较高的丘脑体积相关。较高的皮质下神经纤维化程度与阴性和阳性症状的严重程度轻度相关。结论：精神分裂症患者皮质下体积的增加似乎是药物引起的肥大。这种肥大可能反映了受体阻滞剂的结构适应性，并可能减轻抗精神病药物治疗的影响。
Objective: This study examined whether subcortical volumes of the basal ganglia and thalamus in schizophrenic patients are related to neuroleptic exposure and symptom severity. Method: Basal ganglia substructures and thalamic volumes were measured with magnetic resonance imaging in 96 patients with schizophrenia (50 men and 46 women) and 128 healthy comparison subjects (60 men and 68 women). Twenty-one of the patients were neuroleptic-naive; of the 75 previously treated patients, 48 had received typical neuroleptics only, and 27 had received typical and atypical neuroleptics. The relation of volume measures to treatment status, exposure to neuroleptics, and symptoms was examined. Results: The neuroleptic-naive patients did not differ from the healthy comparison subjects in subcortical volumes except for lower thalamic volume. In the neuroleptic-naive group, volumes did not correlate with severity of negative symptoms, but higher volumes in both the thalamus and the putamen were associated with more severe positive symptoms. The previously treated group showed higher volumes in the putamen and globus pallidus than the healthy comparison subjects and the neuroleptic-naive patients. in the treated group, a higher dose of a typical neuroleptic was associated with higher caudate, putamen, and thalamus volumes, whereas a higher dose of an atypical neuroleptic was associated only with higher thalamic volume. Higher subcortical Volumes were mildly associated with greater severity of both negative and positive symptoms. Conclusions: Increased subcortical volumes in treated schizophrenic patients seem to be medication-induced hypertrophy. This hypertrophy could reflect structural adaptation to receptor blockade and may moderate the effects of neuroleptic treatment.