精神分裂症脑的死后结构分析:研究设计和数据解释。

Psychiatric developments Pub Date : 1988-01-01
F M Benes
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引用次数: 0

摘要

本文讨论了在设计精神分裂症脑组织学研究时必须考虑的各种因素。对1952年之前文献的研究表明,本世纪上半叶出现的许多争议可以在方法论缺陷的背景下理解,包括使用不适当的控制,缺乏对精神分裂症的系统诊断,缺乏盲目定量,最后,未能控制几个潜在的混杂变量的影响。除了后一种问题,精神分裂症大脑的死后结构分析的设计还必须考虑哪些大脑区域是合理的检查,应该评估哪些形态参数来测试一个有问题的假设,以及所记录的任何差异是否代表大脑的主要,次要或甚至是次要的变化。在这些设计中应该考虑到精神分裂症患者的生命周期,以便将精神分裂症的内在因素,如遗传特征标记或围产期侮辱的影响,与后来可能出现的变化(可能与获得缺陷状态有关)区分开来。神经生物学和临床精神病学的基本原理应该应用于设计和解释出现的数据。考虑到所有这些问题,将需要复杂的策略来获得可靠、有效和临床相关的信息,这些信息可以有助于我们对精神分裂症病理生理学的理解。
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Post-mortem structural analyses of schizophrenic brain: study designs and the interpretation of data.

This paper discusses various factors that must be considered in designing histological studies of schizophrenic brain. An examination of the literature prior to 1952 reveals that much of the controversy arising during the first half of this century can be understood within the context of methodological flaws that included the use of inappropriate controls, the lack of systematic diagnosis of schizophrenia, an absence of blind quantitation and finally, a failure to control for the effects of several potential confounding variables. In addition to these latter concerns, the design of post-mortem structural analyses of schizophrenic brain must also consider what brain areas are reasonable to examine, what morphometric parameters should be evaluated to test a hypothesis in question and whether any differences noted represent primary, secondary or perhaps even epiphenomenal changes in the brain. The life cycle of schizophrenic patients should be considered in these designs so that factors intrinsic to the disorder, such as a genetic trait marker or the effects of perinatal insult, can be distinguished from changes that may arise later, perhaps in relation to the acquisition of the defect state. The basic principles of neurobiology and clinical psychiatry should be applied in developing a design and in interpreting data that emerges. Taking all of these issues into account, complex strategies will be required in order to obtain reliable, valid and clinically relevant information that can contribute to our understanding of the pathophysiology of schizophrenia.

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