PDF(Pubmed)
Abstract：
BACKGROUND: Lateral ventricular enlargement represents a canonical morphometric finding in chronic patients with schizophrenia; however, longitudinal studies elucidating complex dynamic trajectories of ventricular volume change during critical early disease stages are sparse.
METHODS: We measured lateral ventricular volumes in 113 first-episode schizophrenia patients (FES) at baseline visit (11.7 months after illness onset, SD = 12.3) and 128 age- and sex-matched healthy controls (HC) using 3T MRI. MRI was then repeated in both FES and HC one year later.
RESULTS: Compared to controls, ventricular enlargement was identified in 18.6% of patients with FES (14.1% annual ventricular volume (VV) increase; 95%CI: 5.4; 33.1). The ventricular expansion correlated with the severity of PANSS-negative symptoms at one-year follow-up (p = 0.0078). Nevertheless, 16.8% of FES showed an opposite pattern of statistically significant ventricular shrinkage during ≈ one-year follow-up (-9.5% annual VV decrease; 95%CI: -23.7; -2.4). There were no differences in sex, illness duration, age of onset, duration of untreated psychosis, body mass index, the incidence of Schneiderian symptoms, or cumulative antipsychotic dose among the patient groups exhibiting ventricular enlargement, shrinkage, or no change in VV.
CONCLUSIONS: Both enlargement and ventricular shrinkage are equally present in the early stages of schizophrenia. The newly discovered early reduction of VV in a subgroup of patients emphasizes the need for further research to understand its mechanisms.
METHODS: We measured lateral ventricular volumes in 113 first-episode schizophrenia patients (FES) at baseline visit (11.7 months after illness onset, SD = 12.3) and 128 age- and sex-matched healthy controls (HC) using 3T MRI. MRI was then repeated in both FES and HC one year later.
RESULTS: Compared to controls, ventricular enlargement was identified in 18.6% of patients with FES (14.1% annual ventricular volume (VV) increase; 95%CI: 5.4; 33.1). The ventricular expansion correlated with the severity of PANSS-negative symptoms at one-year follow-up (p = 0.0078). Nevertheless, 16.8% of FES showed an opposite pattern of statistically significant ventricular shrinkage during ≈ one-year follow-up (-9.5% annual VV decrease; 95%CI: -23.7; -2.4). There were no differences in sex, illness duration, age of onset, duration of untreated psychosis, body mass index, the incidence of Schneiderian symptoms, or cumulative antipsychotic dose among the patient groups exhibiting ventricular enlargement, shrinkage, or no change in VV.
CONCLUSIONS: Both enlargement and ventricular shrinkage are equally present in the early stages of schizophrenia. The newly discovered early reduction of VV in a subgroup of patients emphasizes the need for further research to understand its mechanisms.
摘要：
背景：侧脑室扩大是慢性精神分裂症患者的典型形态测量结果；然而，阐明关键早期疾病阶段心室容积变化的复杂动态轨迹的纵向研究很少。
方法：我们测量了113例首发精神分裂症患者（FES）在基线就诊时（发病后11.7个月，SD=12.3）和128个年龄和性别匹配的健康对照（HC），使用3TMRI。然后一年后在FES和HC中重复MRI。
结果：与对照组相比，18.6%的FES患者发现心室扩大(年心室容积(VV)增加14.1%;95CI:5.4;33.1).1年随访时心室扩张与PANSS阴性症状的严重程度相关(p=0.0078)。然而，在约1年随访期间，16.8％的FES显示出相反的具有统计学意义的心室收缩模式（VV年度下降-9.5％；95CI：-23.7；-2.4）。性别没有差异，疾病持续时间,发病年龄,未治疗精神病的持续时间，身体质量指数,施耐德症状的发生率，或在出现心室扩大的患者组中累积抗精神病药剂量，收缩，或者VV没有变化。
结论：扩大和心室收缩在精神分裂症的早期阶段同样存在。新发现的患者亚组中VV的早期降低强调需要进一步研究以了解其机制。
方法：我们测量了113例首发精神分裂症患者（FES）在基线就诊时（发病后11.7个月，SD=12.3）和128个年龄和性别匹配的健康对照（HC），使用3TMRI。然后一年后在FES和HC中重复MRI。
结果：与对照组相比，18.6%的FES患者发现心室扩大(年心室容积(VV)增加14.1%;95CI:5.4;33.1).1年随访时心室扩张与PANSS阴性症状的严重程度相关(p=0.0078)。然而，在约1年随访期间，16.8％的FES显示出相反的具有统计学意义的心室收缩模式（VV年度下降-9.5％；95CI：-23.7；-2.4）。性别没有差异，疾病持续时间,发病年龄,未治疗精神病的持续时间，身体质量指数,施耐德症状的发生率，或在出现心室扩大的患者组中累积抗精神病药剂量，收缩，或者VV没有变化。
结论：扩大和心室收缩在精神分裂症的早期阶段同样存在。新发现的患者亚组中VV的早期降低强调需要进一步研究以了解其机制。
