BIOLOGICAL BASIS OFTHE PSYCHOSOCIALTREATMENTFOR SCHIZOPHRENIA

为了阐明精神分裂症心理社会治疗的生物学基础，使用统计参数图(SPM)99进行了结构和生理神经成像研究。使用基于体素的形态计量学对整个大脑进行的综合评估显示，磁共振成像(MRI)灰质的结构差异。结果表明，分裂型障碍具有与精神分裂症相似但程度较轻的形态异常。在眼眶额叶、内侧颞叶和脑室周围区域观察到的灰质减少的共性可能代表精神分裂症的易感性，额叶内侧区域的额外受累可能是精神分裂症患者出现鲜艳精神症状的关键。这些提示了精神分裂症的颞额两步发展过程：颞叶的变化可能构成精神分裂症的易感性，额叶…的额外变化可能是精神分裂症的易感性更多的L叶可能会引发精神病症状。此外，我们还研究了用神经影像方法诊断精神分裂症的可能性。SPM99提取的灰质变化模式的主成分分析在精神分裂症、分裂型和对照受试组中区分最多。第一种模式将患者扫描与健康对照扫描分开，第二种模式区分精神分裂症患者和分裂型障碍患者。采用低分辨率电磁层析成像(LORETA)对听觉事件相关电位进行评估。使用主成分分析提取了区分精神分裂症患者和对照组的P300时间范围内皮质激活峰值的模式。神经生理学模式也显示了内侧前额叶区域的病理性异常。这些结果表明，神经影像学方法阐明精神分裂症谱系障碍的脑病理可能对临床诊断有价值。较少

In order to elucidate the biological basis of the psychosocial treatment for schizophrenia, structural and physiological neuroimaging studies were conducted using the Statistical Parametric Mapping(SPM) 99. A comprehensive assessment throughout the brain using the voxel-based morphometry showed structural differences in the gray matter of magnetic resonance imaging(MRI). Results indicated that schizotypal disorder possesses similar but less extent morphological abnormalities to schizophrenia. Observed commonalities of gray matter reductions in the orbital frontal, medial temporal and periventricular regions may represent the vulnerability to schizophrenia, and additional involvement of the medial frontal regions may be essential to develop the florid psychotic symptoms in schizophrenia. These suggested the temporo-frontal two-step processes for the development of schizophrenia : the temporal lobe changes may constitute vulnerability to schizophrenia and additional changes in the fronta … More l lobes may elicit psychotic symptoms. Moreover, we studied the possibility of diagnosis of schizophrenia using neuroimaging methods. A principal component analysis of SPM99 extracted patterns of gray matter changes differentiating most among schizophrenia, schizotypal, and control subject groups. The first pattern separated patient scans from healthy comparison scans, and the second pattern discriminated patients with schizophrenia from patients with schizotypal disorder. The auditory event-related potential was evaluated using the Low Resolution Electromagnetic Tomography(LORETA). Patterns of cortical activation maxima in the P300-timeframe differentiating schizophrenia patients from controls were extracted using a principal component analysis. Neurophysiological pattern also demonstrated pathognomonic abnormalities in the medial prefrontal region. These results indicate that the neuroimaging approach to elucidate brain pathologies of schizophrenia spectrum disorder might be of value for clinical diagnosis. Less