Voxel-based structural magnetic resonance imaging (MRI) study of patients with early onset schizophrenia.
Voxel-based structural magnetic resonance imaging (MRI) study of patients with early onset schizophrenia.
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DOI：
10.1186/1744-859x-7-25
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发表时间：
2008-12-22
影响因子：
3.7
通讯作者：
Takei, Nori
中科院分区：
文献类型：
--
作者：
Yoshihara, Yujiro;Sugihara, Genichi;Takei, Nori
背景：迄今为止，对早发性精神分裂症（EOS）全脑形态学的研究很少。我们研究了EOS患者的区域脑容量，以及区域容量测量与症状严重程度之间的相关性。方法：共检查18例发病年龄在16岁以下的EOS患者和18例年龄、性别、父母社会经济地位和身高相匹配的对照组。采用脑分析形态学映射（BAMM）软件包进行基于体素的形态学分析，探讨EOS患者区域灰质（GM）和白质（WM）体积的变化。使用阳性和阴性症状量表（PANSS）评估症状。结果：与对照组相比，EOS患者左侧海马旁、额下回和颞上回的GM体积显著减少。左后肢内囊和左下纵束的WM体积也较小。PANSS阳性症状评分（越高症状越严重）与双侧扣带回GM体积呈负相关。阴性症状评分与右丘脑GM体积呈正相关。在与WM体积的相关性方面，PANSS阳性症状评分与小脑WM（蚓区）呈正相关，与脑干（脑桥）和双侧小脑（半球区）的WM呈负相关。结论：我们在EOS患者中发现的GM和WM的区域性体积改变与先前对成年起病精神分裂症患者的研究结果一致。然而，在EOS患者与对照组之间没有整体结构差异的大脑区域（即双侧扣带回后区、右侧丘脑、小脑和脑桥），单独对EOS患者进行的受试者内分析显示，这些区域的体积与症状严重程度存在显著关联。这些发现表明，在疾病的早期阶段，特别是对于那些在大脑成熟之前发病的患者，广泛的神经回路紊乱，包括那些没有表现出明显形态变化的大脑区域，可能有助于症状的形成。
BACKGROUND: Investigation into the whole brain morphology of early onset schizophrenia (EOS) to date has been sparse. We studied the regional brain volumes in EOS patients, and the correlations between regional volume measures and symptom severity.METHODS: A total of 18 EOS patients (onset under 16 years) and 18 controls matched for age, gender, parental socioeconomic status, and height were examined. Voxel-based morphometric analysis using the Brain Analysis Morphological Mapping (BAMM) software package was employed to explore alterations of the regional grey (GM) and white matter (WM) volumes in EOS patients. Symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS).RESULTS: EOS patients had significantly reduced GM volume in the left parahippocampal, inferior frontal, and superior temporal gyri, compared with the controls. They also had less WM volume in the left posterior limb of the internal capsule and the left inferior longitudinal fasciculus. The positive symptom score of PANSS (higher values corresponding to more severe symptoms) was negatively related to GM volume in the bilateral posterior cingulate gyrus. The negative symptom score was positively correlated with GM volume in the right thalamus. As for the association with WM volume, the positive symptom score of PANSS was positively related to cerebellar WM (vermis region), and negatively correlated with WM in the brain stem (pons) and in the bilateral cerebellum (hemisphere region).CONCLUSION: Our findings of regional volume alterations of GM and WM in EOS patients coincide with those of previous studies of adult onset schizophrenia patients. However, in brain regions that had no overall structural differences between EOS patients and controls (that is, the bilateral posterior cingulate gyrus, the right thalamus, the cerebellum, and the pons), within-subject analysis of EOS patients alone revealed that there were significant associations of the volume in these areas and the symptom severity. These findings suggest that at an early stage of the illness, especially for those with onset before brain maturation, a wide range of disturbed neural circuits, including these brain regions that show no apparent morphological changes, may contribute to the formation of the symptomatology.