psychiatryПСИХИАТРИЯPsychiatry (Moscow) (Psikhiatriya)1683-83192618-6667FSBSI “The Mental Health Research Centre”; LLC «Publisher «MIA»10.30629/2618-6667-2024-22-4-102-114psychiatry-1223Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWSСтруктурные особенности головного мозга у больных хронической шизофренией с различными типами функциональных исходовStructural Brain Characteristics of Chronic Schizophrenia Patients with Different Types of Functional Outcomehttps://orcid.org/0000-0001-6688-4329ТомышевА. С.TomyshevA. S.

Александр Сергеевич Томышев, кандидат биологических наук, старший научный сотрудник, лаборатория нейровизуализации и мультимодального анализа

Москва

Alexander S. Tomyshev, Cand. Sci. (Biol.), Senior Researcher, Laboratory of Neuroimaging and Multimodal Analysis

Moscow

alexander.tomyshev@gmail.comhttps://orcid.org/0000-0002-0021-4936ГолубевС. А.GolubevS. A.

Сергей Александрович Голубев, доктор медицинских наук, заместитель главного врача по первичной медико-санитарной помощи; ведущий научный сотрудник, отдел юношеской психиатрии

Москва

Sergey A. Golubev, Dr. Sci. (Med.), Deputy Chief Physician for Primary Health Care; Department of Youth Psychiatry

Moscow

color1982@bk.ruhttps://orcid.org/0000-0002-3997-1782ДудинаА. Н.DudinaA. N.

Анастасия Николаевна Дудина, младший научный сотрудник, лаборатория нейровизуализации и мультимодального анализа

Москва

Anastasia N. Dudina, Junior Researcher, Laboratory of Neuroimaging and Multimodal Analysis

Moscow

andudina95@gmail.comhttps://orcid.org/0000-0002-6031-5907БожкоО. В.BozhkoO. V.

Ольга Васильевна Божко, кандидат медицинских наук, врач-рентгенолог, отделение лучевых и компьютерно-томографических исследований

Москва

Olga V. Bozhko, Cand. Sci. (Med.), radiologist, Unit of Ray and Computed Tomography

Moscow

bozhko_olga@mail.ruhttps://orcid.org/0000-0003-3001-7842ТихоновД. В.TikhonovD. V.

Денис Витальевич Тихонов, кандидат медицинских наук, старший научный сотрудник, отдел юношеской психиатрии

Москва

Denis V. Tikhonov, Cand. Sci. (Med.), Senior Researcher, Department of Youth Psychiatry

Moscow

denvt@list.ruhttps://orcid.org/0000-0002-1209-1443КаледаВ. Г.KaledaV. G.

Василий Глебович Каледа, доктор медицинских наук, профессор, заведующий отделом, отдел юношеской психиатрии, заместитель директора

Москва

Vasiliy G. Kaleda, Dr. Sci. (Med.), Professor, Head of Department, Department of Youth Psychiatry, deputy director

Moscow

kaleda-vg@ncpz.ruhttps://orcid.org/0000-0002-0649-6663ЛебедеваИ. С.LebedevaI. S.

Ирина Сергеевна Лебедева, доктор биологических наук, заведующий лабораторией, лаборатория нейровизуализации и мультимодального анализа

Москва

Irina S. Lebedeva, Dr. Sci. (Biology), Head of Laboratory, Laboratory of Neuroimaging and Multimodal Analysis

Moscow

irina.lebedeva@ncpz.ruФГБНУ «Научный центр психического здоровья»РоссияFSBSI “Mental Health Research Centre”Russian FederationГБУЗ «Психиатрическая клиническая больница № 4 им. П.Б. Ганнушкина ДЗМ»; ФГБНУ «Научный центр психического здоровья»РоссияFSIH Gannushkin Psychiatric Clinical Hospital No4 Leading Researcher; FSBSI “Mental Health Research Centre”Russian Federation202409112024224102114Copyright © Томышев А.С., Голубев С.А., Дудина А.Н., Божко О.В., Тихонов Д.В., Каледа В.Г., Лебедева И.С., 20242024Томышев А.С., Голубев С.А., Дудина А.Н., Божко О.В., Тихонов Д.В., Каледа В.Г., Лебедева И.С.Tomyshev A.S., Golubev S.A., Dudina A.N., Bozhko O.V., Tikhonov D.V., Kaleda V.G., Lebedeva I.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.journalpsychiatry.com/jour/article/view/1223

Обоснование: исследования, позволяющие изучать нейробиологические особенности длительно текущего шизофренического процесса, обладают высокой значимостью как для клинической практики, так и биологической психиатрии. Цель исследования: определение морфометрических особенностей головного мозга хронически больных шизофренией с различными типами функционального исхода. Пациенты и методы: осуществлен анализ морфометрических МРТ показателей коры головного мозга и подкорковых образований у 46 пациентов с диагнозом шизофрении с большой продолжительностью болезни (средняя длительность 20,5 ± 6,7 лет), и у 35 подобранных по полу и возрасту психически здоровых испытуемых из контрольной группы. Результаты и их обсуждение: у больных в целом выявлена меньшая толщина серого вещества в ряде областей коры больших полушарий. При оценке исхода с использованием клинико-психопатологического, клинико-катамнестического и клинико-эпидемиологического методов предположительным маркером худшего функционального исхода и плохого качества ремиссии оказалось билатеральное увеличение объемов бледного шара и скорлупы. В то же время при оценке исхода на основе текущих психометрических показателей социального функционирования и клинической симптоматики оказалось, что у пациентов с неблагоприятным вариантом исхода толщина серого вещества снижена в двух областях поясной коры в отличие от здорового контроля и в сравнении с пациентами с благоприятным исходом. Однако отсутствие корреляций с клиническими шкалами и показателями функционирования ограничивает возможность сделать вывод о специфичности указанного снижения как маркера исхода. Выводы: полученные результаты могут только предварительно предполагать существование различных нейроанатомических подтипов (биотипов), ассоциированных с различными функциональными исходами у больных хронической шизофренией.

Background: studies allowing to explore the neurobiological characteristics of the long-term schizophrenic process are of high significance for both clinical practice and biological psychiatry. Objective: to examine morphometric brain characteristics in chronic schizophrenia patients with different types of functional outcomes. Patients and methods: morphometric MRI characteristics of the cerebral cortex and subcortical structures are analysed in 46 patients with schizophrenia with a long disease durations (20.5 ± 6.7 years), and in 35 mentally healthy subjects matched by sex and age. Results and discussion: the whole group of patients showed decreased gray matter thickness in some cerebral cortex regions. When outcome was assessed using clinical-psychopathologic, clinical-catamnestic, and clinical-epidemiologic methods, bilateral increases in pallidum and putamen volumes were found to be a presumptive marker of worse functional outcome and remission poor quality. At the same time, when outcome was assessed on the basis of the current psychometric measures of social functioning and clinical symptomatology, patients with an unfavorable outcome were characterized by decreased gray matter thickness in the two cingulate cortex regions compared to both healthy controls and patients with a good outcome. However, the absence of correlations with clinical scales and functioning doesn’t allow a conclusion on the specificity of this decrease as a marker of outcome. Conclusion: the results may only presume beforehand the existence of different neuroanatomical subtypes (biotypes) associated with different functional outcomes in patients with chronic schizophrenia.

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The authors declare that there are no conflicts of interest present.