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1.
精神分裂症患者脑CT与临床的10年随访研究   总被引:5,自引:0,他引:5  
目的探讨精神分裂症的脑萎缩与临床表现的相关性。方法对32例精神分裂症患者的脑CT与临床进行了10年的随访研究,采用简明精神病评定量表、阴性症状量表、阳性症状量表、社会功能缺陷筛选量表、简易智力状态检查对其临床症状、社会功能和智能状况进行评定。结果10年前32例患者中有5例(16%)脑萎缩,10年后为10例(31%)脑萎缩;8例脑室大小正常,但双侧脑室不对称;14例正常。随访时量表评定结果提示,该组患者以阴性症状为主,社会功能下降,认识功能有不同程度的损害,脑萎缩患者与非脑萎缩患者比较,差异未见显著性,但病程明显长于非脑萎缩患者。精神分裂症患者的脑萎缩与精神病家族史、亚型和各项治疗无明显关系。结论精神分裂症患者的脑结构异常与病程呈正相关。  相似文献   

2.
目的分析正常老年人(NC)与认知功能相对保存的慢性老年精神分裂症(S1)、认知功能缺损的慢性老年精神分裂症(S2)及Alzheimer病(AD)、S1与S2之间认知和脑萎缩情况的异同,探索慢性分裂症认知功能减退的本质及器质性基础。方法应用一组神经心理测验与头颅CT扫描检测41例NC、19例S1、19例S2及38例AD患者。结果4组样本以认知功能评定成绩好坏依次排序:NC为最好;其次为S1,S2和AD最差。S2的认知损害模式与AD有所不同。脑CT测量显示的脑萎缩程度:AD最重,其后的是顺序为S2,S1,NC。S1与NC相比,存在以颞叶萎缩为主的局灶性损害,S2组脑萎缩较S1组弥漫且严重,但较AD轻。结论提示S2组认知功能损害是精神分裂症的自然结果,而不是因为合并了AD;精神分裂症有可能是一种异质性疾病。  相似文献   

3.
儿童精神分裂症患者微小躯体异常与脑室扩大关系的研究   总被引:2,自引:0,他引:2  
目的探讨儿童精神分裂症患者微小躯体异常(MPAs)与脑室扩大的关系。方法对168例儿童精神分裂症患者(患者组)进行躯体异常量表(WS)评定,并将患者分为MPAs明显组(WS总分≥4分,85例)和MPAs不明显组(WS总分≤3分,83例)。用阳性和阴性症状量表(PANSS)评定患者组的精神症状;用CT测量患者的脑室(脑室值用哈氏值、三脑室宽度、脑室指数、侧脑室体部指数、侧脑室宽度指数、前角指数表示),并与40名健康儿童(对照组)进行对照。结果(1)患者组哈氏值[(5.37±0.53)cm]和三脑室宽度[(3.83±1.21cm)]均大于对照组[分别为(4.94±0.34)cm和(3.16±0.41)cm],腩室指数(1.55±0.18)和前角指数(3.52±0.31)小于对照组(分别为1.65±0.22和3.77±0.34),均P〈0.01。(2)MPAs明显组哈氏值[(5.50±0.54)cm]和三脑室宽度[(4.10±1.32)cm]大于MPAs不明显组[分别为(5.24±0.49)cm和(3.55±1.01)cm]和对照组,前角指数(3.47±0.30)小于MPAs不明显组(3.57±0.31)和对照组,脑室指数(1.55±0.18)小于对照组。(3)MPAs不明显组哈氏值大于对照组,脑室指数和前角指数小于对照组,均P〈0.01和P〈0.05。(4)患者组WS总分与哈氏值(r=0.263)及三脑室宽度(r=0.287)存在正相关,与前角指数存在负相关(r=-0.178);患者组的WS总分与阴性症状分呈正相关(r=0.247);患者组的阴性症状分与哈氏值(r=0.375)和三脑室宽度(r=0.161)呈正相关,与脑室指数(r=-0.159)和前角指数(r=-0.191)呈负相关(均P〈0.01和P〈0.05)。结论儿童精神分裂症患者存在显著的MPAs和脑室扩大,MPAs与脑室扩大之间有明显的相关。  相似文献   

4.
双相情感性精神障碍与精神分裂症脑CT扫描比较   总被引:2,自引:0,他引:2  
为了比较双相情感性精神障碍、精神分裂症病人脑结构的变化,收集符合国际疾病分类第10版和中国精神疾病分类方案与诊断标准第2版修订本的双相情感性精神障碍病人27例,以及精神分裂症病人25例,应用脑CT定量分析脑室、脑沟。结果显示,双相情感性精神障碍和精神分裂症病人前角指数、第三脑室最大宽度、乳突间比值和脑萎缩差异均无显著性(P>0.05)。提示精神分裂症和双相情感性精神障碍这些所谓的功能性疾病可能和非特异性脑室、脑沟结构异常相关。  相似文献   

5.
精神分裂症与脑结构异常   总被引:1,自引:0,他引:1  
目的探讨精神分裂症与脑结构异常的关系。方法对143例精神分裂症进行MRI检查。结果143例精神分裂症中有脑萎缩33例,其中表现为脑室对称性扩大7例(5.17%),皮质萎缩8例(5.75%),同侧脑室扩大伴皮质萎缩18倒(12.64%),脑萎缩与性别、家族史、药物治疗、电休克治疗之间未发现正相关。结论精神分裂症患者有脑器质性改变的可能,且与患者病程有关。  相似文献   

6.
脑静脉窦血栓形成螺旋CT的临床应用   总被引:1,自引:0,他引:1  
目的 探讨螺旋CT(SCT)对静脉窦血栓形成(CVT)的诊断价值.方法 对12例临床怀疑或随诊CVT行SCT检查,并与MRV、脑静脉DSA对照分析.结果 SCT对中大脑静脉窦显示较好,显示率达90%以上.结论 SCT是诊断CVT可靠、有效和快捷的检查方法,尤其对急性或慢性CVT诊断、CVT治疗后随访以及脑水肿、脑出血等脑实质并发症的显示更为准确.  相似文献   

7.
目的探讨脑海绵状血管瘤的CT和MRI诊断,提高其诊断准确性。方法回顾性分析14例经病理证实的脑海绵状血管瘤的CT和MRI影像特点。结果幕上10例:额叶4例,颞叶4例,基底节2例;幕下4例:小脑半球3例,脑干1例。CT表现:14例边界清楚的圆形、类圆形等至稍高密度影,6例合并斑点状钙化;MR表现:14例边界清楚的混杂信号病灶,病灶呈爆米花状,周围有完整的低信号含铁血黄素环。结论 MRI是脑海绵状血管瘤诊断和鉴别诊断最有价值的方法,显示钙化是CT的优势。  相似文献   

8.
目的探讨多层螺旋CT(MSCT)脑灌注成像与测量CT值的差值(△Hu)在急性脑梗死早期诊断中的价值。方法对34例临床拟诊为急性脑梗死的患者行头部CT平扫和脑CT灌注成像。评价脑CT灌注成像的达峰时间(TTP),脑血流量(CBF),脑血容量(CBV),测量两侧对称部位CT值的差值(△Hu)。全部病例37 d内复查头部CT及临床随访。另选取34例无脑部疾病、神经系统功能正常的为对照组。结果 34例病例中,头部CT平扫肉眼观察发现可疑病灶15例,测量对称部位CT值差值发现可疑病灶21例;脑CTP显示:32例脑CTP灌注异常,2例脑CTP灌注正常,脑CTP显示患者感兴趣区内脑血流量(rCBF)、脑血容量(rCBV)、对比剂达峰时间(rTTP)明显改变,病灶侧与对照侧、病灶中心区与周边区比较,差异有显著意义(P<0.01)。头部CT平扫肉眼观察发现病灶的敏感度44.11%,脑CTP发现病灶的敏感度94.11%。结论脑CTP检查能够早期诊断急性脑梗死,定量分析可区分中心梗死区与缺血半暗带区,有助于临床医生判断梗死病灶的存在和早期选择治疗方案。  相似文献   

9.
精神分裂症脑结构的核磁共振研究   总被引:3,自引:0,他引:3  
目的:采用核磁共振技术(MRI)分析精神分裂症患者的脑结构改变。方法:以精神分裂症住院患者101例为对象,正常30例为对照,作头颅核磁共振扫描。结果:病例组第三脑室显著增宽,尾状核体积较大,海马增厚,各部位海马信号强度减弱。结论:精神分裂症患者脑萎缩明显,尾状核增大。  相似文献   

10.
本文报道306例精神分裂症患者脑CT检查结果,发现脑结构异常改变84例(27.45%),其中脑萎缩3例(19.3%),脑皮质萎缩20例(6.5%),小脑萎缩3例(0.98%)。脑萎缩与性别、家族史和药物、电休克、胰岛素治疗之间未发现正相关。  相似文献   

11.
Abnormalities of cerebral lateralization in schizophrenia patients   总被引:1,自引:0,他引:1  
Initial lateral eye movements (LEMs) have been shown to be associated with activation of the contralateral frontal lobes. Using LEM as a criterion measure of activation, schizophrenics were compared to normals with respect to the processing of four types of stimuli: verbal nonemotional (VNE), verbal emotional (VE), spatial nonemotional (SNE), and spatial emotional (SE). Our results indicate that schizophrenics initiate thought in their left hemisphere significantly more often than controls when one compares all test conditions and on VNE, VE, and SE material. Neither medication nor level of education had an appreciable effect on LEM in either group. However, sex was a significant variable; women irrespective of diagnosis consistently used the left hemisphere more often than men. The inappropriate initiation of thought on SE material as well as the overall increase in left hemisphere activity suggest left hemisphere disorder. This is consistent with other findings that suggest a left hemisphere locus of disturbance in schizophrenia.  相似文献   

12.
OBJECTIVE: Diabetes mellitus has been implicated as a risk factor for tardive dyskinesia. The authors examined the association between abnormal movements and impaired glucose metabolism, which often precedes the development of overt diabetes, in patients with schizophrenia. METHOD: Twenty-one patients with DSM-IV schizophrenia receiving neuroleptic medication were given oral glucose tolerance tests involving serial glucose and insulin levels. These values were analyzed in relationship to abnormal involuntary movement ratings. RESULTS: Patients with impaired glucose tolerance had higher mean abnormal movement scores than those without glucose intolerance, but this difference was not statistically significant. There was, however, an association between the magnitude of the fasting insulin level and abnormal movements after the authors controlled for fasting glucose level. Additionally, the fasting glucose level predicted abnormal movements after the authors controlled for age. CONCLUSIONS: Hyperinsulinemia and hyperglycemia associated with insulin resistance may potentially contribute to the pathogenesis of tardive dyskinesia. Findings from this small cross-sectional study suggest a possible relationship that requires clarification through larger, longitudinal studies.  相似文献   

13.
目的探讨精神分裂症患者失匹配负波(mismatch negativity,MMN)的特征及药物对MMN的影响。方法对31例精神分裂症患者(研究组)和30名健康被试(对照组)行MMN的检测,并比较首发未用药组与已用药组MMN潜伏期、波幅的差异。结果(1)研究组和对照组Fz,Cz,Pz点均可见较明显MMN波形,精神分裂症组波形欠规则。(2)研究组Fz、Cz、Pz点的MMN潜伏期较对照组差异无统计学意义(t=0.74,0.09,0.63;P〉0.05);三点波幅降低,较对照组比较差异具有统计学意义(t=5.04,5.83,4.47;P〈0.05)。(3)首发未用药病患组12例和已接受药物治疗的病患组19例,在Fz、Cz、Pz点MMN潜伏期、波幅,差异均未见统计学差异(t=0.59,1.17,1.73,1.88,1.12,0.90;P〉0.05)。结论精神分裂症患者认知功能受损,且MMN是一个稳定的素质性指标,不受药物影响。  相似文献   

14.
Summary Regional cerebral blood flow was evaluated using Tc99m-HMPAO SPECT in 10 medicated patients with schizophrenia and 9 healthy volunteers. There were no prefrontal regions in the patient group with lower regional indices than in the control group. However, in the left hippocampal region, relative blood flow was significantly increased in the patient group compared with the control group. Furthermore, there was a relative increase in blood flow in the left basal ganglia of the patient group. A negative correlation coefficient was calculated between the relative blood flow in the left middle prefrontal cortex and the severity of the blunted affect, as well as between the relative blood flow in the left basal ganglia and the severity of the anhedonia-asociality. These findings indicate that prefrontal hypoactivity is not invariably present in all schizophrenics and that left basal ganglial hyperactivity may be associated with the effects of antipsychotic treatment and clinical improvement. Moreover, the left hippocampal hyperactivity may correspond to left limbic dysfunction in schizophrenia.  相似文献   

15.
In recent years neuroimaging techniques have revealed various cerebral and structural variances in patients with schizophrenic psychoses. The best established findings are the enlargement of the lateral ventricles and discrete structural deficits in temporobasal structures of the cortex. Neuropathological investigations have detected subcortical as well as cortical variances. Subcortically, the volume of the striatum and the globus pallidus have been found to be enlarged in schizophrenics. Among the cortical deviations, the cytoarchitectonic disturbances of the rostral entorhinal region have been well documented and are especially important. According to neuropathological criteria, they are derived from disturbances of prenatal cell migration within the central nervous system. Well documented are the architectonic changes in the rostral cingulate gyrus which is itself connected with the entorhinal region via the Papez circuit. These findings are supported and supplemented by the results of epidemiological studies which indicate a disturbance of brain development during the second trimester of the prenatal period. Viral infections (Influenza A2) of mothers during this critical period appear to play an especially important role. Nevertheless, the interaction between a genetic predisposition and exogenous noxious agents in such cases still needs to be clarified in our understanding of the etiology of schizophrenic psychoses.  相似文献   

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17.
Seventy Japanese DSM-III-R schizophrenic patients were assessed for 30 clinical symptoms using the Positive and Negative Syndrome Scale (PANSS) of Kay et al. Principal component analysis was applied to the full item set of this scale and disclosed 5 orthogonal independent symptom groups: negative, hostile/excited, thought-disordered, delusional/hallucinatory and depressive components. Our results provided further support of the contention that more than 2 (i.e., positive and negative) dimensions are required to account for structures of the schizophrenic symptoms.  相似文献   

18.
Eye tracking and brain morphology assessed by magnetic resonance imaging were examined in 48 patients in their first episode of schizophrenia and in 15 normal controls. Schizophrenic patients showed higher rates of eye tracking dysfunction and more abnormal brain morphology involving the lateral ventricles, medial temporal lobe (MTL) structures and the frontal-parietal cortex than controls. Enlargement of the lateral ventricles and global rating of abnormal brain morphology were significantly more prevalent in male schizophrenics than female schizophrenics. These findings indicate that abnormalities in a variety of brain regions are present in some schizophrenics during the period shortly after the first hospitalization and could not be a function of treatment or chronic illness. We found no relation between abnormal eye tracking and any single feature of abnormal brain morphology. However, normal eye tracking was significantly associated with MTL abnormalities in schizophrenics, reflecting an inverse association between quality of eye tracking and degree of abnormality in MTL structures. These results suggest that abnormal eye tracking is not mediated by the same processes that lead to structural brain anomalies in schizophrenia.  相似文献   

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20.
In an attempt to detect electroencephalographic (EEG) changes associated with characteristic clinical signs and symptoms of schizophrenia, power spectra were derived from scalp EEGs of schizophrenic patients recorded by telemetry during free behaviour on their psychiatric wards. Power spectra from EEG epochs coincident with psychomotor blocking, stereotyped automatism or hallucinations were compared with spectra derived during periods of relatively normal behaviour, during performance of specific tasks and spectra from control subjects. Ramp spectra, characterised by a smooth decline in power from lowest to highest frequencies, previously found in conjunction with subcortical spike activity of epilepsy were not found in any control subject, but appeared in spectra from schizophrenic patients during catatonic episodes, hallucinatory periods and visual checking. Schizophrenic patients also had more slow activity and less alpha activity in their EEGs than normal control subjects.  相似文献   

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