精神分裂症의 側頭葉 病理

Temporal Lobe Pathology in Schizophrenia

Structural changes discovered in the schizophrenic brains suggest abnormalities during the process of brain development. In order to verify the hypothesis of developmental origin of schizophrenia, asymmetries of sylvian fissures and temporal structures related to the planum temporale, which begin to appear approximately 20 weeks of gestation during normal human brain development, were estimated in this study. M R Is were taken as contiguous coronal section(TR/TE = 3000ms/30ms) with 7mm width and contiguous sagittal section(TR/TE = 500ms/20ms) with 5mm width, using 1.0 Tesla SMT-100 scanner. Transferring stored data in the magnetic tape into the optical disk, the morphology and length(mm) of the sylvian fissures, areas(mm2) of the superior temporal gyrus and the middle temporal lobe were measured and compared right-left asymmetries by the automated image analysis system. 1) As compared to the neurotic controls(n = 25)，the SF morphology of H & V-type was significantly prevalent(p〈 0.005) among schizophrenics, particularly among those born in the cold seasons(p〈 0.025). The length of SF was insignificantly longer in the right hemisphere and there were no significant right-left asymmetries. 2) In contrast with controls, areas of the superior temporal gyrus were significantly smaller in left hemisphere of schizophrenics(p〈 0.005)，particularly among those bom in cold seasons ( p 〈0.05) and areas of right superior temporal gyrus were significantly larger among schizophrenics bom in the cold seasons(p〈 0.005). R ight asymmetries were significantly prevalent among schizophrenics(p〈 0.0001), particularly among those bom in the cold seasons(p < 0. 0001). 3) W hile controls had broader areas in left middle temporal lobe, schizophrenics had broader right middle temporal lobe. There were significantly many right asymmetries among schizophrenics( p < 0.0005), particularly among those bom in the cold seasons(p < 0.005). 4) Lengths or areas of the temporal structures were not correlated with variables like age, intelligence (total I.Q .), sex, clinical symptoms and subtypes. The above results reflected reversed asymmetries of temporal structures like SF and planum temporale in schizophrenics in contrast with those seen during normal human brain development. These suggest a kind of developmental origin of etiology in schizophrenia. Furthermore, the fact that such abnormalities were seen in the schizophrenics who were bom in the cold seasons suggest a possibility of viral infection during fetal brain development