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雑誌文献

精神医学52巻4号

2010年04月発行

文献概要

特集 内因性精神疾患の死後脳研究

精神疾患の脳形態画像解析からみた器質的要因

著者: 鬼塚俊明1 中村一太1 神庭重信1

所属機関: 1九州大学大学院医学研究院精神病態医学

ページ範囲:P.321 - P.328

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はじめに

 近年,精神疾患の病態研究として,高解像度magnetic resonance imaging(MRI)を用いた脳画像研究が盛んになってきた。現在では,さまざまな精神疾患において,正常者との微細な脳構造の違いが報告されてきている。灰白質の体積減少の報告が多いが,時にはある脳部位の体積増大も報告されている。注意するべき点として,疾患群で関心領域(region of interest;ROI)の体積が正常対照者と比べて有意に小さい(あるいは大きい)という結果が得られても,それが精神疾患の病態にどのような意義があるかは不明であり,あくまで正常者と異なるパターンであるということを示しているに過ぎないことを理解しておく必要がある。「萎縮」という用語は神経細胞数の減少を示すことが多いので,統合失調症のROIの体積減少は「萎縮」と表現するべきではないと思われる。

 現在の脳形態画像研究から精神疾患における器質的要因を類推することは困難であるが,本稿では死後脳研究,脳機能研究の所見を考慮し,精神疾患の脳形態画像解析からみた器質的要因について述べてみたい。

参考文献

1) Beyer JL, Kuchibhatla M, Payne ME, et al:Hippocampal volume measurement in older adults with bipolar disorder. Am J Geriatr Psychiatry 12:613-620, 2004
2) Davis KL, Stewart DG, Friedman JI, et al:White matter changes in schizophrenia:Evidence for myelin-related dysfunction. Arch Gen Psychiatry 60:443-456, 2003
3) Deng C, Huang XF:Increased density of GABAA receptors in the superior temporal gyrus in schizophrenia. Exp Brain Res 168:587-590, 2006
4) Giuliani NR, Calhoun VD, Pearlson GD, et al:Voxel-based morphometry versus region of interest:A comparison of two methods for analyzing gray matter differences in schizophrenia. Schizophr Res 74:135-147, 2005
5) Glantz LA, Lewis DA:Decreased dendritic spine density on prefrontal cortical pyramidal neurons in schizophrenia. Arch Gen Psychiatry 57:65-73, 2000
6) Hajek T, Carrey N, Alda M:Neuroanatomical abnormalities as risk factors for bipolar disorder. Bipolar Disord 7:393-403, 2005
7) Hakak Y, Walker JR, Li C, et al:Genome-wide expression analysis reveals dysregulation of myelination-related genes in chronic schizophrenia. Proc Natl Acad Sci U S A 98:4746-4751, 2001
8) Highley JR, McDonald B, Walker MA, et al:Schizophrenia and temporal lobe asymmetry. A post-mortem stereological study of tissue volume. Br J Psychiatry 175:127-134, 1999
9) Highley JR, Walker MA, Esiri MM, et al:Schizophrenia and frontal lobes:Post-mortem stereological study of tissue volume. Br J Psychiatry 178:337-343, 2001
10) Honea R, Crow TJ, Passingham D, et al:Regional deficits in brain volume in schizophrenia:A meta-analysis of voxel-based morphometry studies. Am J Psychiatry 162:2233-2245, 2005
11) Kasai K, Shenton ME, Salisbury DF, et al:Progressive decrease of left Heschl gyrus and planum temporale gray matter volume in first-episode schizophrenia:A longitudinal magnetic resonance imaging study. Arc Gen Psychiatry 60:766-775, 2003
12) Koo MS, Levitt JJ, Salisbury DF, et al:A cross-sectional and longitudinal magnetic resonance imaging study of cingulate gyrus gray matter volume abnormalities in first-episode schizophrenia and first-episode affective psychosis. Arch Gen Psychiatry 65:746-760, 2008
13) Lewis DA, Hashimoto T, Volk DW:Cortical inhibitory neurons and schizophrenia. Nat Rev Neurosci 6:312-324, 2005
14) McCarley RW, Salisbury DF, Hirayasu Y, et al:Association between smaller left posterior superior temporal gyrus MRI volume and smaller left temporal P300 amplitude in first episode schizophrenia. Arch Gen Psychiatry 59:321-331, 2002
15) McCrea SM:Bipolar disorder and neurophysiological mechanisms. Neuropsychiatr Dis Treat 4:1129-1153, 2008
16) McDonald B, Highley JR, Walker MA, et al:Anomalous asymmetry of fusiform and parahippocampal gyrus gray matter in schizophrenia:A postmortem study. Am J Psychiatry 157:40-47, 2000
17) Nakamura M, Salisbury DF, Hirayasu Y, et al:Neocortical gray matter volume in first-episode schizophrenia and first-episode affective psychosis:A cross-sectional and longitudinal MRI study. Biol Psychiatry 62:773-783, 2007
18) Onitsuka T, Niznikiewicz MA, Spencer KM, et al:Functional and structural deficits in brain regions subserving face perception in schizophrenia. Am J Psychiatry 163:455-462, 2006
19) Salisbury DF, Kuroki N, Kasai K, et al:Progressive and interrelated functional and structural evidence of post-onset brain reduction in schizophrenia. Arch Gen Psychiatry 64:521-529, 2007
20) Selemon LD, Goldman-Rakic PS:The reduced neuropil hypothesis:A circuit based model of schizophrenia. Biol Psychiatry 45:17-25, 1999
21) Selemon LD, Rajkowska G, Goldman-Rakic PS:Abnormally high neuronal density in the schizophrenic cortex. A morphometric analysis of prefrontal area 9 and occipital area 17. Arch Gen Psychiatry 52:805-818, 1995
22) Shenton ME, Dickey CC, Frumin M, et al:A review of MRI findings in schizophrenia. Schizophr Res 49:1-52, 2001
23) Sweet RA, Bergen SE, Sun Z, et al:Pyramidal cell size reduction in schizophrenia:Evidence for involvement of auditory feedforward circuits. Biol Psychiatry 55:1128-1137, 2004
24) Sweet RA, Bergen SE, Sun Z, et al:Anatomical evidence of impaired feedforward auditory processing in schizophrenia. Biol Psychiatry 61:854-864, 2007
25) Sweet RA, Henteleff RA, Zhang W, et al:Reduced dendritic spine density in auditory cortex of subjects with schizophrenia. Neuropsychopharmacology 34:374-389, 2009
26) Sweet RA, Pierri JN, Auh S, et al:Reduced pyramidal cell somal volume in auditory association cortex of subjects with schizophrenia. Neuropsychopharmacology 28:599-609, 2003
27) Walker MA, Highley JR, Esiri MM, et al:Estimated neuronal populations and volumes of the hippocampus and its subfields in schizophrenia. Am J Psychiatry 159:821-828, 2002

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-126X

印刷版ISSN:0488-1281

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