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脳画像研究により,統合失調症の脳構造に対する理解は飛躍的に増大した。Voxel-based morphometryは統合失調症研究にも応用され,さまざまな知見が蓄積している。統合失調症では,前頭葉,側頭葉,辺縁系における容積低下,そして辺縁系における容積増加が認められる。これらは発症初期から認められ,病状の進行に伴い萎縮の範囲が広がっていく。これらの知見をどう臨床に還元するかが今後の課題である。
Abstract
Various imaging studies have employed voxel based morphometry (VBM) to detect local volume reductions in schizophrenia. Indeed, the first study of VBM was applied to patients with schizophrenia. Patients with schizophrenia show reduced volume in frontal, temporal (especially superior temporal gyrus, parahippocampal gyrus, and amygdala), and limbic regions (including insula and anterior cingulate cortex). Patients also show an increased volume in striatal regions. Even patients with first-episode show volume reduction and the reduced regions extend in accordance with the pathological process, which supports both the neurodevelopmental hypothesis and the neurodegenerative hypothesis. The challenge is how to feedback this accumulated evidence to the clinical practice.
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