Aberrant Paranasal Sinus Development in Schizophrenia

 描述(申请人提供)：在精神分裂症患者中，嗅觉系统的破坏已经得到了很好的描述；据报道，患者有心理物理缺陷，嗅球/皮质变小，后鼻腔体积减少。然而，这些发现可能源于神经发育或退行性疾病。相反，窦体积的改变表明在胚胎发育的特定窗口发生了中断。具体地说，上颌窦和筛窦在出生前发育，额窦和蝶窦在出生后发育。因此，鼻窦的不同发育模式可以让我们更准确地探测到，在发育过程中，精神疾病高危患者和已经患病的患者中，神经发育“第一次打击”发生在哪里。我们将对15名临床风险(CR)受试者、15名早期精神病(EP)患者和30名匹配的健康对照受试者的副鼻窦进行高分辨率CT扫描。鼻窦的体积评估将与心理物理嗅觉性能的标准化评估以及鼻腔/腭部体积和几何形状的量化评估一起进行。我们的工作模型是，窦的形态和体积的破坏反映了胚胎发育的异常，这反过来可能被用作后来精神病发病的风险标志。

 DESCRIPTION (provided by applicant): Disruption of the olfactory system has been well-described in patients with schizophrenia; with psychophysical deficits, smaller olfactory bulb/cortex and reduced posterior nasal volume in patients being reported. These findings, however, could be either neurodevelopmental or degenerative in origin. In contrast, alterations of sinus volume are indicative of disruptions occurring during a specific window of embryologic development. Specifically, the 1) maxillary and 2) ethmoid sinuses develop prenatally and the 3) frontal and 4) sphenoid sinuses develop postnatally. As such, differential development patterns of the sinuses can allow us to probe more precisely where in the developmental process the neurodevelopmental "first hit" occurs in patients at-risk for psychosis and in patients who have already become ill. We will obtain high-resolution CT scans of the paranasal sinuses in 15 clinical risk (CR) subjects, 15 early psychosis (EP) patients, and 30 matched healthy-comparison subjects. Volumetric assessment of the sinuses will be performed along with standardized assessments of psychophysical olfactory performance and quantified assessments of nasal/palate volume and geometry. Our working model is that disruptions of sinus morphology and volume reflect abnormalities in embryological development that may in turn be used as a risk marker for the later onset of psychosis.