Aberrant Paranasal Sinus Development in Schizophrenia

 描述（由申请方提供）：在精神分裂症患者中已充分描述了嗅觉系统的破坏;报告了患者的心理生理缺陷、嗅球/皮层较小和后鼻容积减少。然而，这些发现可能是神经发育或退行性的起源。相反，窦体积的改变表明在胚胎发育的特定窗口期间发生的破坏。具体来说，1）上颌窦和2）筛窦在出生前发育，3）额窦和4）蝶窦在出生后发育。因此，鼻窦的不同发育模式可以使我们更精确地探测在发育过程中神经发育的“第一次打击”发生在有精神病风险的患者和已经生病的患者中。我们将在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中获得鼻窦的高分辨率CT扫描。将沿着进行鼻窦体积评估以及心理物理嗅觉性能的标准化评估和鼻/腭体积和几何形状的量化评估。我们的工作模型是，窦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精神病后期发病的风险标志。

 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.