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Longitudinal Assessment of Gray and White Matter in Chronic Schizophrenia: A Combined Diffusion-Tensor and Structural Magnetic Resonance Imaging Study

机译:慢性精神分裂症的灰色和白色物质的纵向评估:扩散张量和结构磁共振成像的组合研究

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摘要

Previous studies have reported continued focal gray matter loss after the clinical onset of schizophrenia. Longitudinal assessments in chronic illness, of white matter in particular, have been less conclusive.We used diffusion-tensor and structural magnetic resonance imaging in 16 healthy subjects and 49 chronic schizophrenia patients, subdivided into good-outcome (n=23) and poor-outcome (n=26) groups, scanned twice 4 years apart. Fractional anisotropy, gray matter and white matter volumes were parcellated into the Brodmann’s areas and entered into multiway ANCOVAs.At baseline, schizophrenia patients had 1) lower anisotropy in frontoparietal white matter, 2) larger posterior frontal white matter volumes, and 3) smaller frontal, temporal, and parietal gray matter volumes. On follow-up, healthy subjects showed a more pronounced 1) decline in anisotropy, 2) expansion of regional white matter volumes, and 3) reduction in regional gray matter volumes than schizophrenia patients. Good-outcome patients showed a more pronounced decline in white matter anisotropy and a less pronounced increase in white matter volumes than poor-outcome patients. Poor-outcome patients displayed a greater gray matter loss throughout the brain than good-outcome patients.In the chronic phase of the illness, longitudinal changes in both gray and white matter are in the direction of an effacement of between-group differences among schizophrenia patients and healthy subjects. Similarly, preexisting white matter differences between good-outcome and poor-outcome patients diminish over time. In contrast, gray matter volumes in poor-outcome patients continue to decline more rapidly than in patients with good outcome. These patterns are consistent with earlier onset of aging-associated changes in schizophrenia.
机译:先前的研究报道了精神分裂症临床发作后持续的局灶性灰质损失。在慢性疾病,特别是白质疾病的纵向评估中,结论性较差。我们在16位健康受试者和49位慢性精神分裂症患者中使用扩散张量和结构磁共振成像,分为好结果(n = 23)和差结果(n = 26)组,每4年扫描两次。分数各向异性,灰质和白质体积被分解到Brodmann区域,并进入多路ANCOVA。精神分裂症患者在基线时具有以下特征:1)额前白质各向异性较低,2)额后白质体积较大,3)额叶较小,颞叶和顶叶灰质体积。在随访中,健康的受试者显示出比精神分裂症患者更明显的1)各向异性降低,2)区域白质量增加和3)区域灰质量减少。与不良结果患者相比,好结果患者显示出白质各向异性的下降更为明显,而白质体积的增加则不那么明显。较差的患者在大脑中的灰质损失要比较差的患者更大。在疾病的慢性期,精神分裂症患者之间的灰阶和白质的纵向变化都朝着消除群体间差异的方向发展和健康的对象。同样,好结果患者和差结果患者之间先前存在的白质差异随时间减少。相比之下,治疗效果差的患者的灰质物质下降继续比治疗效果好的患者的灰质下降更快。这些模式与精神分裂症中与衰老相关的变化的早期发作是一致的。

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