Orkun AYDIN, Duygu KUZU, Artuner DEVECİ, Kadir AŞÇIBAŞI

ÖZET Şizofreni ile kavum septum pellusidum arasındaki ilişki: Bir olgu sunumu

Şizofreni ile kavum septum pellusidum arasındaki ilişki: Bir olgu sunumu Lateral ventriküllerin medial duvarını oluşturan septum pellucidum iki laminadan oluşan ince bir tabakadır. Kavum septum pellucidum (KSP), septum pellucidumun iki yaprağı arasındaki bir boşluktur. KSP'un şizofreni ile ilişkili nörogelişimsel bir anomali olduğu düşünülmektedir. Normal fetal gelişimde septum pellucidumun oluşumu hipokampus, amigdala, korpus kallosum, septal nükleus gibi komşu limbik yapılarla eş zamanlı olmaktadır. Bu yüzden septum pellucidumda saptanan anatomik farklılıklar, komşu anatomik yapıların embriyonal gelişim bozukluklarını yansıtabilir. Birkaç manyetik rezonans görüntüleme çalışmasında, şizofreni hastalarında normal kişilere göre daha yüksek prevalansta geniş KSP saptanmıştır. Psikiyatrik bozukluklarla ilgili literatüre baktığımızda KSP'nin en çok şizofreni ile bağlantılı olduğunu görebiliriz. Geniş KSP şizofreninin etyolojik nedenlerinden biri olarak gösterilen nörogelişimsel modeli desteklemektedir. Biz bu olgu sunumunda, manyetik rezonans görüntüleme yöntemi ve nörobilişsel yeti yitimini tartıştık

The Relationship Between Schizophrenia and Cavum Septum Pellucidum: A Case Study

The relationship between schizophrenia and cavum septum pellucidum: a case studySeptum pellucidum that forming the medial wall of the lateral ventricles, a thin layer is formed by two laminae. Cavum septum pellucidum (CSP), a space between the two leaflets of the septi pellucidi, is thought to be a neurodevelopmental anomaly associated with schizophrenia. In normal fetal development, the formation of septum pellucidum occurs at the same time with the development of the neighboring limbic system structures such as hippocampus, amygdala, corpus callosum, septal nucleus. Therefore, the anatomical differences that are detected in the septum pellucidum may reflect the embryonal development disorders of the adjacent anatomical structures. Several magnetic resonance imaging studies have reported a higher prevalence of enlarged CSP in patients with schizophrenia than in normal subjects. In the literature of psychiatric disorders, CSP is most associated with schizophrenia. Wide CSP may support the neurodevelopmental etiology of schizophrenia. In this report we present a schizophrenia case. And we tried to discuss the patient’s clinical appearance and neurocognitive disability

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1. Hallak JE, Crippa JA, Pinto JP, Machado de Sousa JP, Trzesniak C, Dursun SM, McGuire P, Deakin JF, Zuardi AW. Total agenesis of the corpus callosum in a patient with childhood-onset schizophrenia. Arq Neuropsiquiatr 2007; 65:1216-1219.
2. David AS, Wacharasindhu A, Lishman WA. Severe psychiatric disturbances and abnormalities of the corpus callosum. J Neurol Neurosurg Psychiatry 1993; 56:85-93.
3. Swayze VW, Andreasen NC, Ehrhardt JC, Yuh WT, Alliger RJ, Cohen GA. Developmental abnormalities of the corpus callosum in schizophrenia. Arch Neurol 1990; 47:805-808.
4. Sarwar M. The septum pellucidum: normaland abnormal. AJNR Am J Neuroradiol 1989; 10:989-1005.
5. Shaw CM, Alvord EC. Cavum septi pellucidi et vergae: their normal and pathological states. Brain 1969; 92:213-223.
6. Kim KJ, Peterson BS. Cavum septi pellucidi in Tourette syndrome. Biol Psychiatry 2003; 54:76-85.
7. Nopoulos P, Swayze V, Flaum M, Ehrhardt JC, Yuh WT, Andreasen NC. Cavum septi pellucidi in normals and patients with schizophrenia as detected by magnetic resonance imaging. Biol Psychiatry 1997; 41:1102-1108.
8. Kwon JS, Shenton ME, Hirayasu Y, Salisbury DF, Fischer IA, Dickey CC, Yurgelun-Todd D, Tohen M, Kikinis R, Jolesz FA, McCarley RW. MRI study of cavum septi pellucidi in schizophrenia, affective disorder, and schizotypal personality disorder. Am J Psychiatry 1998; 155:509-515.
9. Bodensteiner JB, Schaefer GB, Craft JM. Cavum septi pellucidi and cavum vergae in normal and developmentally delayed populations. J Child Neurol 1998; 13:120-121.
10. Hagino H, Suzuki M, Kurokawa K, Mori K, Nohara S, Takahashi T, Yamashita I, Yotsutsuji T, Kurachi M, Seto H. Magnetic resonance imaging study of the cavum septi pellucidi in patients with schizophrenia. Am J Psychiatry 2001; 158:1717-1719.
11. Kasai K, McCarley RW, Salisbury DF, Onitsuka T, Demeo S, Yurgelun-Todd D, Kikinis R, Jolesz JA, Shenton ME. Cavum septi pellucidi in first-episode schizophrenia and first-episode affective psychosis: an MRI study. Schizophr Res 2004; 71:65-76.
12. DeLisi LE, Hoff AL, Kushner M, Degreef G. Increased prevalence of cavum septum pellucidum in schizophrenia. Psychiatry Res 1993; 50:193-199.
13. Flashman LA, Roth RM, Pixley HS, Cleavinger HB, McAllister TW, Vidaver R, Saykin AJ. Cavum septum pellucidum in schizophrenia: clinical and neuropsychological correlates. Psychiatry Res 2007; 154:147-155.
14. Shenton ME, Dickey CC, Frumin M, McCarley RW. A review of MRI findings in schizophrenia. Schizophr Res 2001; 49:1-52.
15. Coulter CL, Leech RW, Schaefer GB, Scheithauer BW, Brumback RA. Midline cerebral dysgenesis, dysfunction of the hypothalamicpituitary axis, and fetal alcohol effects. Arch Neurol 1993; 50:771- 775.
16. Chen CP, Lin SP, Chang TY, Chiu NC, Shih SL, Lin CJ, Wang W, Hsu HC. Perinatal imaging findings of inherited Sotos syndrome. Prenat Diagn 2002; 22:887-892.
17. Yacubian-Fernandes A, Palhares A, Giglio A, Gabarra RC, Zanini S, Portela L, Plese JP. Apert syndrome: analysis of associated brain malformations and conformational changes determined by surgical treatment. J Neuroradiol 2004; 31:116-122.
18. Dickey CC, McCarley RW, Xu ML, Seidman LJ, Voglmaier MM, Niznikiewicz MA, Connor E, Shenton ME. MRI abnormalities of the hippocampus and cavum septi pellucidi in females with schizotypal personality disorder. Schizophr Res 2007; 89:49-58.
19. de Souza Crippa JA, Zuardi AW, Busatto GF, Sanches RF, Santos AC, Araújo D, Amaro E, Hallak JE, Ng V, McGuire PK. Cavum septum pellucidum and adhesio interthalamica in schizophrenia: an MRI study. Eur Psychiatry 2006; 21:291-299.
20. Schaefer GB, Bodensteiner JB, Thompson JN Jr. Subtle anomalies of the septum pellucidum and neurodevelopmental deficits. Dev Med Child Neurol 1994; 36:554-559.
21. Nopoulos PC, Giedd JN, Andreasen NC, Rapoport JL. Frequency and severity of enlarged cavum septi pellucidi in childhood-onset schizophrenia. Am J Psychiatry 1998; 155:1074-1079.
22. Bruyn G. Agenesis septi pellucidi, cavum septi pellucidi, cavum vergae, and cavum veli interpositi: In Vinken PJ, Bruyn GW (editors). Handbook of Clinical Neurology, Vol. 30. Amsterdam: Elsevier 1977; 299-366.
23. Nopoulos P, Krie A, Andreasen NC. Enlarged cavum septi pellucidi in patients with schizophrenia: clinical and cognitive correlates. J Neuropsychiatry Clin Neurosci 2000; 12:344-349.
24. Kim SW, Chung YC, Lee YH, Lee JH, Kim SY, Bae KY, Kim JM, Shin IS, Yoon JS. Paliperidone ER versus risperidone for neurocognitive function in patients with schizophrenia: a randomized, openlabel, controlled trial. Int Clin Psychopharmacol 2012; 27:267- 274.
25. Aydemir O. Functioning in schizophrenia and paliperidone: a review of studies with personal and social performance scale. Bulletin of Clinical Psychopharmacology 2009; 19 (Suppl.2):335- 340.