Brain volume changes in first-episode schizophrenia - A 1-year follow-up study
Brain volume changes in first-episode schizophrenia - A 1-year follow-up study
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DOI：
10.1001/archpsyc.59.11.1002
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发表时间：
2002-11-01
影响因子：
--
通讯作者：
Kahn, RS
中科院分区：
文献类型：
--
作者：
Cahn, W;Pol, HEH;Kahn, RS
背景资料：对精神分裂症患者的影像学研究表明，大脑异常很大程度上局限于灰质体积减少以及侧脑室内和第三脑室内的扩大。据报道，儿童期发作和慢性精神分裂症患者的整体灰质体积逐渐减少。首发精神分裂症患者的整体灰质体积尚未进行纵向检查。人们会期望全球灰质逐渐减少，特别是在首发患者，因为临床恶化是最大的疾病的早期阶段，diseases.Methods患者首发精神分裂症谁采取了抗精神病药物治疗0至16周（n = 34）和匹配的健康对照组（n = 36）被列入本研究。对于所有受试者，在入选时和1年后（平均值[SD]，12.7 [1.1]个月）获得全脑磁共振成像扫描。在入选后2年测量结局。为了比较患者和健康对照受试者随时间的形态学变化，以颅内体积作为协变量进行了多次重复测量方差分析。结果：患者的脑体积（-1.2%）和大脑灰质体积（-2.9%）显著减少，侧脑室体积显著增加（7.7%）。全球灰质体积的减少显着相关的结果，独立的，与抗精神病药物的累积剂量较高。结论：全球灰质的损失在精神分裂症是进行性的，发生在疾病的早期阶段，并与疾病的过程和抗精神病药物。
Background: Imaging studies of patients with schizophrenia have demonstrated that brain abnormalities are largely confined to decreases in gray matter volume and enlargement of the lateral and third ventricles. Global gray matter volume has been reported to progressively decrease in childhood-onset and chronic schizophrenia. Global gray matter volumes have not been examined longitudinally in patients with first-episode schizophrenia. One would expect global gray matter to decrease progressively, particularly in first-episode patients, because clinical deterioration is greatest in the early stages of the disease.Methods Patients with first-episode schizophrenia who had taken antipsychotic medication for 0 to 16 weeks (n = 34) and matched healthy comparison subjects (n = 36) were included in the study. For all subjects, magnetic resonance imaging scans of the whole brain were obtained at inclusion and after 1 year (mean [SD], 12.7 [1.1] months). Outcome was measured 2 years after inclusion. To compare morphological changes over time between patients and healthy comparison subjects, multiple repeated-measures analyses of variance were conducted with intracranial volume as a covariate. Outcome and cumulative antipsychotic medication were related to changes in patients' brain volumes.Results: Total brain volume (-1.2%) and gray matter volume of the cerebrum (-2.9%) significantly decreased and lateral ventricle volume significantly increased (7.7%) in patients. The decrease in global gray matter volume significantly correlated with outcome and, independently of that, with higher cumulative dosage of antipsychotic medication.Conclusions: The loss of global gray matter in schizophrenia is progressive, occurs at an early stage of the illness, and is related to the disease process and antipsychotic medication.