Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia.
Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia.
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DOI：
10.1056/nejm199003223221201
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发表时间：
1990-03
期刊：
影响因子：
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通讯作者：
R. Suddath;G. Christison;E. Torrey;M. Casanova;D. Weinberger
中科院分区：
文献类型：
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作者：
R. Suddath;G. Christison;E. Torrey;M. Casanova;D. Weinberger
最近的神经放射学和神经病理学研究表明，至少有一些精神分裂症患者脑室轻微增大，海马前部区域有细微的解剖异常。我们使用磁共振成像（MRI）研究了15对精神分裂症不一致的同卵双胞胎（年龄范围25 - 44岁，8男7女）。对每对双胞胎进行t1加权连续冠状切片（5mm厚）的盲比较，并用计算机图像分析系统对大脑结构进行定量测量。在15对不一致的双胞胎中，有12对通过脑脊液间隙的目视检查确定了患有精神分裂症的双胞胎。有两对在视觉上看不出差异，其中一对患有精神分裂症的双胞胎被认错了。通过海马体水平的切片定量分析显示，与正常双胞胎相比，15名患病双胞胎中有14名的海马体左侧较小，13名患病双胞胎的海马体右侧较小（P均小于0.001）。在患有精神分裂症的双胞胎中，与正常双胞胎相比，14例左侧侧脑室增大（P < 0.003）， 13例右侧侧脑室增大（P < 0.001）。在患有精神分裂症的双胞胎中，有13人的第三脑室也较大（P < 0.001）。在没有精神分裂症的七对同卵双胞胎中没有发现这些差异，他们被当作对照组进行了类似的研究。我们的结论是，大脑解剖结构的细微异常（即海马前部小，侧脑室和第三脑室增大）是精神分裂症的一贯神经病理学特征，其原因至少部分不是遗传的。需要进一步的研究来确定这些变化是原发的还是继发的。
Recent neuroradiologic and neuropathological studies indicate that at least some patients with schizophrenia have slightly enlarged cerebral ventricles and subtle anatomical abnormalities in the region of the anterior hippocampus. Using magnetic resonance imaging (MRI), we studied 15 sets of monozygotic twins who were discordant for schizophrenia (age range, 25 to 44 years; 8 male and 7 female pairs). For each pair of twins, T1-weighted contiguous coronal sections (5 mm thick) were compared blindly, and quantitative measurements of brain structures were made with a computerized image-analysis system. In 12 of the 15 discordant pairs, the twin with schizophrenia was identified by visual inspection of cerebrospinal fluid spaces. In two pairs no difference could be discerned visually, and in one the twin with schizophrenia was misidentified. Quantitative analysis of sections through the level of the pes hippocampi showed the hippocampus to be smaller on the left in 14 of the 15 affected twins, as compared with their normal twins, and smaller on the right in 13 affected twins (both P less than 0.001). In the twins with schizophrenia, as compared with their normal twins, the lateral ventricles were larger on the left in 14 (P less than 0.003) and on the right in 13 (P less than 0.001). The third ventricle also was larger in 13 of the twins with schizophrenia (P less than 0.001). None of these differences were found in seven sets of monozygotic twins without schizophrenia who were studied similarly as controls. We conclude that subtle abnormalities of cerebral anatomy (namely, small anterior hippocampi and enlarged lateral and third ventricles) are consistent neuropathologic features of schizophrenia and that their cause is at least in part not genetic. Further study is required to determine whether these changes are primary or secondary to the disease.