RESUMEN
The aim of this study was to investigate the neural substrate underlying quality of life (QoL) and to demonstrate the microstructural abnormalities associated with impaired QoL in a large sample of patients with schizophrenia, using magnetisation transfer imaging. A total of 81 right-handed men with a diagnosis of schizophrenia and 25 age- and sex-similar healthy controls were included and underwent a 3T MRI with magnetization transfer ratio (MTR) to detect microstructural abnormalities. Compared with healthy controls, patients with schizophrenia had grey matter (GM) decreased MTR values in the temporal lobe (BA21, BA37 and BA38), the bilateral insula, the occipital lobe (BA17, BA18 and BA19) and the cerebellum. Patients with impaired QoL had lower GM MTR values relative to patients with preserved QoL in the bilateral temporal pole (BA38), the bilateral insula, the secondary visual cortex (BA18), the vermis and the cerebellum. Significant correlations between MTR values and QoL scores (p < 0.005) were observed in the GM of patients in the right temporal pole (BA38), the bilateral insula, the vermis and the right cerebellum. Our study shows that QoL impairment in patients with schizophrenia is related to the microstructural changes in an extensive network, suggesting that QoL is a bio-psychosocial marker.
Asunto(s)
Encéfalo/ultraestructura , Sustancia Gris/ultraestructura , Imagen por Resonancia Magnética , Esquizofrenia/diagnóstico por imagen , Adolescente , Adulto , Encéfalo/patología , Corteza Cerebral/patología , Corteza Cerebral/ultraestructura , Sustancia Gris/patología , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Neuronas/metabolismo , Calidad de Vida , Radiografía , Esquizofrenia/patología , Encuestas y Cuestionarios , Lóbulo Temporal/patología , Lóbulo Temporal/ultraestructuraRESUMEN
We report three cases of pathological gambling induced by aripiprazole, in patients with schizophrenia or schizoaffective disorder. All three patients had no history of pathological gambling, and they started gambling after initiation of treatment with Aripiprazole. The fact that pathological behaviour disappears quickly as medication was ended suggests that an elaborate behavioral manifestation could be related to dopaminergic tone in patients with schizophrenia. We recommend consideration with increased attention for the appearance of pathological gambling symptoms among patients on Aripiprazole.