REGIONAL BRAIN ABNORMALITIES IN SCHIZOPHRENIA MEASURED WITH MAGNETIC-RESONANCE-IMAGING
REGIONAL BRAIN ABNORMALITIES IN SCHIZOPHRENIA MEASURED WITH MAGNETIC-RESONANCE-IMAGING
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DOI：
10.1001/jama.272.22.1763
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发表时间：
1994-12-14
影响因子：
120.7
通讯作者：
YUH, WTC
中科院分区：
文献类型：
--
作者：
ANDREASEN, NC;FLASHMAN, L;YUH, WTC
客观。-确定精神分裂症脑结构异常的一般和区域指标。病例对照比较研究。根据精神疾病诊断和统计手册第三版修订的标准诊断为精神分裂症的52名患者与从社区招募的90名健康志愿者进行了比较。使用磁共振获取脑结构图像;使用体积渲染的脑的三维可视化和特定区域的自动化基于图谱的解剖获得测量结果。一般测量包括总脑组织、总脑脊液（CSF）和脑室系统内CSF的体积。区域测量包括额叶、颞叶、顶叶、枕叶和小脑的组织体积和CSF。与对照组相比，患者的总脑组织平均体积较小，总CSF和脑室CSF平均体积较大。仅在额叶中发现脑组织的特定相对减少，尽管在所有脑区域中，患者的CSF体积大于对照组。除了在精神分裂症中观察到的全身性脑异常外，额叶区域也可能存在区域性异常。由于额叶整合了多模态信息，并执行了精神分裂症患者受损的各种“高级”认知和情感功能，因此额叶异常与疾病的临床表现一致。额叶功能受损及其复杂回路（包括丘脑皮质投射）的中断可能解释了为什么精神分裂症患者在形成概念和组织思维和行为方面往往存在严重缺陷。
Objective.-To determine general and regional indices of structural brain abnormality in schizophrenia.Design.-Case-control comparison study.Subjects.-Fifty-two patients diagnosed as having schizophrenia according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, were compared with 90 healthy volunteers recruited from the community.Measurements.-Structural brain images were acquired using magnetic resonance; measurements were obtained using three-dimensional visualization of volume-rendered brains and an automated atlas-based dissection of specific regions. General measures included the volume of total brain tissue, total cerebrospinal fluid (CSF), and CSF within the ventricular system. Regional measures included the volume of tissue and CSF in the frontal; temporal, parietal, and occipital lobes and the cerebellum.Results.-Compared with the controls, the patients had a smaller average volume of total brain tissue and a greater average volume of total and ventricular CSF. A specific relative decrease in brain tissue was found only in the frontal lobes, although the volume of CSF was greater in patients than in controls in all brain regions.Conclusion.-In addition to the generalized brain abnormalities observed in schizophrenia, a regional abnormality may be present in frontal regions. Since the frontal lobes integrate multimodality information and perform a variety of ''higher'' cognitive and emotional functions that are impaired in schizophrenia, the frontal abnormality noted is consistent with the clinical presentation of the illness. Impaired frontal function and a disruption in its complex circuitry (including thalamocortical projections) may explain why patients with schizophrenia often have significant deficits in formulating concepts and organizing their thinking and behavior.