No CrossRef data available.
Article contents
Asociación entre mayor cantidad de líquido cefalorraquídeo frontal y duración de la enfermedad en varones pero no en mujeres con esquizofrenia
Published online by Cambridge University Press: 12 May 2020
Resumen
Objetivo
Se ha reconocido una cantidad mayor de líquido cefalorraquídeo (LCR) cortical como un posible marcador de una pérdida de sustancia gris. Esta cantidad mayor en la esquizofrenia se encuentra predominantemente en las regiones prefrontal y temporal. Planteamos la hipótesis de que la evolución global y la respuesta al tratamiento peores en los varones con esquizofrenia se relacionan con una pérdida mayor de volumen cortical comparado con las mujeres.
Sujetos y métodos
Para comprobar esta hipótesis hemos utilizado imágenes de resonancia magnética (IRM) para estudiar los valores de LCR cortical (prefrontal, temporal y hemisférico) en un grupo de 85 pacientes con esquizofrenia, 56 de los cuales eran varones y 29, mujeres. Calculamos los valores residuales de LCR en los pacientes a partir de los datos relativos a 45 sujetos de control y regresión lineal, de los que se descontaron los efectos normales de la edad y el volumen intracraneal. Estas puntuaciones residuales constituyen una medida cuantitativa de la cantidad mayor de LCR debida a la enfermedad.
Resultados
Los hombres, pero no las mujeres, presentaron una cantidad mayor significativa en el nivel de tendencia de LCR prefrontal izquierdo. Los valores residuales prefrontales y temporales se asociaban significativamente con la duración de la enfermedad en los varones, pero no en las mujeres.
Discusión
Estos resultados son compatibles con la peor evolución y la mayor gravedad de las anomalías estructurales encontradas por lo general en la esquizofrenia en los sujetos varones.
Conclusion
Nuestros datos apoyan la hipótesis de una pérdida cortical prefrontal acelerada en los varones, pero no en las mujeres con esquizofrenia.
- Type
- Artículo original
- Information
- Copyright
- Copyright © European Psychiatric Association 2005
References
Bibliografía
[1]Andreasen, NCRajarethinam, RCizadlo, TArndt, S, Swayze 2nd, V, OL, DS, et al. Regional brain abnormalities in schizophrenia measured with magnetic resonance !maging. J Am Med Assoc 1994; 272:1763-9.CrossRefGoogle Scholar
[2]Andreasen, NCRajarethinam, RCizadlo, TArndt, SSwayze 2nd, VWFlashman, LA, et al. Automatic atlas-based volume estimation of human brain regions from MR images. J Comput Assist Tomogr 1996; 20:98–106.CrossRefGoogle ScholarPubMed
[3]Ashburner, JFnston, KJ. Multimodal image coregistration and partitioning— a unified framework. Neuroimage 1997; 6:209-17.CrossRefGoogle ScholarPubMed
[4]Ashburner, JFriston, KJ. Voxel-based morphometry—the methods. Neuroimage 2000; 11:805-21.CrossRefGoogle Scholar
[5]Beiser, MBean, GErickson, DZhang, Jlacono, WGRector, NA. Biological and psychosocial predictors o f job performance following a first episode of psychosis. Am J Psychiatry 1994; 151:857- 63.Google Scholar
[6]Cannon, TDvan Erp, TGHuttunen, MLonnqvist, JSalonen, OValanne, L, et al. Regional gray matter, white matter, and cerebrospinal fluid distributions in schizophrenic patients, their siblings, and Controls. Arch Gen Psychiatry 1998; 55:1084-91.CrossRefGoogle ScholarPubMed
[7]Cannon, TDvan Erp, TGHuttunen, MLonnqvist, JSalonen, OValanne, L, et al. Regional gray matter, white matter, and cerebrospinal fluid distnbutions in schizophrenic patients, their siblings, and Controls. Arch Gen Psychiatry 1998; 55:1084-91.CrossRefGoogle ScholarPubMed
[8]Childers, SEHarding, CM. Gender, promorbid social functioning, and long-term outcome in DSM-1II schizophrenia. Schizophr Bull 1990; 16:309-1CrossRefGoogle Scholar
[9]DeLisi, LESakuma, MTew, WKushner, MHoff, ALGrimson, R. Schizophrenia as a chronic active brain process: a study of Progressive brain structural change subsequent to the onset of schizophrenia. Psychiatry Res 1997; 74:129-40.CrossRefGoogle ScholarPubMed
[10]Deseo, MBenito, CLópez, JSantos, AReig, SMolina, V, et al. Quantification of multimodality studies in schizophrenia. In: Lemke, H, editor. Computer assisted radiology and surgery. Amsterdam: Elsevier; 1999. p. 218-22.Google Scholar
[11]Deseo, MPascau, JReig, SGispert, JDSantos, ABenito, B, et al. Multimodality image quantification using Talairach grid. Proc SPIE Medical Imaging 2001; 4422: 1385-92.Google Scholar
[12]Gur, RCMozley, PDResnick, SMGottlieb, GLKohn, MZimmerman, R, et al. Gender differences in age effect on brain atrophy measflred by magnetic resonance imaging. Proc Nati Acad Sci USA 1991; 88:2845-9.CrossRefGoogle ScholarPubMed
[13]Gur, RECowell, PTuretsky, BIGallacher, FCannon, TBilker, W, et al. A follow-up magnetic resonance imaging study of schizophrenia. Relationship of neuroanatomical changas to clinical and neurobehavioral measures. Arch Gen Psychiatry 1998; 55:145-52.Google Scholar
[14]Gur, REMozley, PDShtasel, DLCannon, TDGallacher, FTuretsky, B, et al. Clinical subtypes of schizophrenia: differences in brain and CSF volume. Am J Psychiatry 1994; 151:343-50.Google ScholarPubMed
[15]Gur, RETuretsky, BIBilker, WBGur, RC. Reduced gray matter volume in schizophrenia. Arch Gen Psychiatry 1999; 56:905-11.CrossRefGoogle Scholar
[16]Harms, CLautenschlager, MBergk, AKatchanov, JFreyer, DKapinya, K, et al. Differential mechanisms of neuroprotection by 17 betaestradiol in apoptotic versus necrotic neurodegeneration. J Neurosci 2001; 21:2600-9.CrossRefGoogle Scholar
[17]Harrison, GCroudace, TMason, PGlazebrook, CMedley, I. Predicting the long-term outcome o f schizophrenia. Psychol Med 1996; 26:697–705.CrossRefGoogle Scholar
[18]Hollingshead, AFrederick, R. Social stratification and psychiatric disorders. Am Soc Rev 1953; 18:163-89.Google Scholar
[19]Honda, KShimohama, SSawada, HKihara, TNakamizo, TShibasaki, H, et al. Nongenomic antiapoptotic signal transduction by estrogen in cultured cortical neurons. J Neurosci Res 2001; 64:466-75.CrossRefGoogle ScholarPubMed
[20]Lauriello, JHoff, AWieneke, MHBlankfeld, HFaustman, WORosenbloom, M, et al. Similar extent of brain dysmorphology in severely ill women and men with schizophrenia. Am J Psychiatry 1997; 154:819-25.Google ScholarPubMed
[21]Lieberman, JChakos, MWu, HAlvir, JHoffman, ERobinson, D, et al. Longitudinal study of brain morphology in first episode schizophrenia. Biol Psychiatry 2001; 49:487-99.CrossRefGoogle ScholarPubMed
[22]Lieberman, JAKoreen, ARChakos, MSheitman, BWoerner, MAlvir, JM, et al. Factors influencing treatment response and outcome of first-episode schizophrenia: implications for understanding the pathophysiology of schizophrenia. J Clin Psychiatry 1996; 57(Suppl 9):5–9.Google ScholarPubMed
[23]Maccioni, RBMunoz, JPBarbeito, L. The molecular bases of Alzheimer's disease and other neurodegenerative disorders. Arch Med Res 2001; 32:367-81.CrossRefGoogle ScholarPubMed
[24]Molina, VReig, SSanz, JBenito, CPascau, JCollazos, F, et al. Association between relative frontal and temporal cortical CSF and illness duration in schizophrenia. Schizophr Res 2002; 58:305-12.CrossRefGoogle Scholar
[25]Molina, VReig, SSarramea, FSanz, JArtaloytia, JLuque, R, et al. Anatomical and functional brain variables associated to clozapine response in treatment-resistant schizophrenia. Psychiatry Res Neuroimaging 2005; 124:153-61.CrossRefGoogle Scholar
[26]Nasrallah, HASchwarzkopf, SBOlson, SCCoffman, JA. Gender differences in schizophrenia on MRI brain scans. Schizophr Bull 1990; 16:205-10.CrossRefGoogle ScholarPubMed
[27]Nopoulos, PFlaum, MAndreasen, NC. Sex differences in brain morphology in schizophrenia. Am J Psychiatry 1997; 154:1648-54.CrossRefGoogle Scholar
[28]Pfefferbaum, ALim, KOZipursky, RBMathalon, DHRosenbloom, MJLane, B, et al. Brain gray and white matter volume loss accelerates with aging in chronic alcoholics: a quantitative MRI study. Alcohol Clin Exp Res 1992; 16:1078-89.CrossRefGoogle ScholarPubMed
[29]Rapoport, JLGiedd, JNBlumenthal, JHamburger, SJeffries, NFernandez, T, et al. Progressive cortical change during adolescence in childhood-onset schizophrenia. A longitudinal magnetic resonance imaging study. Arch Gen Psychiatry 1999; 56:649-54.Google ScholarPubMed
[30]Schneider, LSFinch, CE. Can estrogens prevent neurodegeneration? Drugs Aging 1997; 11:87–95.CrossRefGoogle ScholarPubMed
[31]Schultz, SKMiller, DDOliver, SEArndt, SFlaum, MAndreasen, NC. The life course of schizophrenia: age and symptom dimensions. Schizophr Res 1997; 23:15–23.CrossRefGoogle ScholarPubMed
[32]Stoltzner, SEBerchtold, NCColman, CWPike, CJ. Estrogen regulates bcl-x expression in rat hippocampus. Neuroreport 2001; 12:2797-800.CrossRefGoogle ScholarPubMed
[33]Sullivan, EVLim, KOMathalon, DMarsh, LBeal, DMHarris, D, et al. A profile of cortical gray matter volume deficits characteristic of schizophrenia. Cereb Cortex 1998; 8:117-24.CrossRefGoogle ScholarPubMed
[34]Talairach, JTournoux, P. Co-planar stereotaxic atlas of the human brain. New York: Thieme Medical; 1988.Google Scholar
[35]Woods, BT. Is schizophrenia a progressive neurodevelopmental disorder? Toward a unitary pathogenetic mechanism. Am J Psychiatry 1998; 155:1661-70.CrossRefGoogle Scholar