뇌전산화단층촬영에서 관찰되는 정신분열증 환자의 뇌위축과 그 임상적 의의에 관한 연구

초록

The aim of this study is to investigate brain atrophy and its clinical significance in schizophrenics. For this purpose, the author have taken brain computerized tomography on 45 schizophrenis and 45 controls, and Ventricular-Brain Ratio, the width of third ventricle and interhemispheric fissure, the third ventricle-Sylvian fissure/skull ratio, and the sum of 4 sulci were measured. Then, 45 schizophrenics were divided into enlarged group and not enlarged group by the cutoff point 1SD above the mean values of Ventricular-Brain Ratio, the width of third ventricle and the sum of 4 sulci of the control group, and possible differences of clinical features between two groups were studied. The data were analyzed by the t-test, two-way ANOVA and multiple regression analysis. The results were as follows; 1. The mean of Ventricular-Brain Ratio of schizophrenics was significantly larger than that of controls(P<.01). The Ventricular-Brain Ratio of 17 schizophrenics(37.78% exceeded 1 SD of the control mean. 2. The mean of width of third ventricle in schizophrenics was significantly greater than that of third ventricle in controls(P<.0l). In 14 schizophrenics(31.11%), the width of third ventricle exceeded 1 SD of the control mean. 3. The mean of sum of 4 sulci in schizophrenics was significantly higher than that of controls (P<.05). In 9 schizophrenics(20.00%), the sum of 4 sulci exceeded 1 SD of the control mean. 4. Neither the width of interhemispheric fissure nor the third ventricle-Sylvian fissure/skull ratio demonstrated significant differences between schizophrenics and controls. There was no schizophrenics exceeding 1 SD of the control means of Ventricular-Brain Ratio, width of third ventricle and sum of 4 sulci concomitanly. 5. There was a relationship between Ventricular-Brain Ratio and age of onset of schizophrenics(P<.05), but the duration of illness was not correlated with lateral ventricular size. The extent of which the age of onset had an effect on ventricular-Brain Ratio was calculated by multiple regression analysis( the formula : Ventricular-Brain Ratio = 5.819±0.109 × age of onset). This result suggested that lateral ventriclular enlargement predated the onset of illness and was not a result of the course of illness. 6. Maximum dosage of antipsychotics( P<.0l) and duration of medication( P<.05) in enlarged group of third ventricle were significantly greater than that of not enlarged group, and duration of medication in not enlarged group of sulci was significantly longer than that of enlarged group in schizophrenics(P<.05).

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