医护人员职业倦怠状况调查

目的了解临床医护人员的职业倦怠状况,为预防和干预职业倦怠提供科学依据。方法采用职业倦怠调查问卷对崇州市三家医院的临床医护人员进行横断面调查。结果情感耗竭维度:女性高于男性[(24.74±7.25)vs.(21.97±7.43)],医生高于护士[(23.58±7.45)vs.(20.26±7.14)],低职称高于高职称[(22.76±7.43)vs.(18.15±7.18)],低学历高于高学历[(22.62±7.26)vs.(18.97±7.48)];成就感降低维度:男性高于女性[(25.48±5.24)vs.(23.50±5.10)],已婚高于未婚[(21.71±4.73)vs.(24.80±5.12)],医生高于护士[(25.74±5.39)vs.(22.75±4.70)],高职称高于低职称[(28.05±6.08)vs.(22.35±4.86)]、高学历高于低学历[(25.36±5.28)vs.(22.45±6.60)],均差异有统计学意义(P<0.05或0.01);人格解体维度:各变量差异无统计学意义(P>0.05)。结论医护人员的职业倦怠水平随人口学特征的不同而有差异,女性、医生、未婚、低职称、低学历的医务人员是预防和干预的重点人群。     

社区康复联合药物治疗对农村社区精神分裂症患者康复的效果

目的研究社区康复联合药物治疗对农村社区精神分裂症患者康复的效果,为我国农村地区精神分裂症患者社区康复提供参考。方法选择兰州新区三个镇农村社区中符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的患者81例,按随机数字表法分为研究组(n=39)和对照组(n=42),两组均接受一般药物治疗,研究组在此基础上接受6个月的社区康复干预。于干预前后采用阳性和阴性症状量表(PANSS)、日常生活能力量表(ADL)、社会功能缺陷筛选量表(SDSS)和精神分裂症患者生活质量量表(SQLS)评定两组患者的精神病性症状、社会功能和生活质量。结果干预后,研究组PANSS总评分[(55.54±14.75)分vs.(63.52±13.95)分,t=-2.504,P=0.014]、阴性症状[(15.64±4.50)分vs.(18.38±5.13)分,t=-2.547,P=0.013]和一般精神病理分量表评分[(25.67±7.39)分vs.(30.35±6.60)分,t=-3.015,P=0.003]均低于对照组;研究组SDSS总评分[(8.21±3.78)分vs.(10.21±4.67)分,t=-2.118,P=0.037]和SQLS总评分[(18.97±6.23)分vs.(22.43±8.04)分,t=2.150,P=0.035]均低于对照组,差异均有统计学意义。结论社区康复联合药物治疗可能有助于减轻农村社区精神分裂症患者的精神病性症状,提高社会功能,改善生活质量。     

心肺耦合技术检测惊恐障碍睡眠特征研究北大核心CSCD

目的利用心肺耦合(cardiopulmonary coupling,CPC)技术检测惊恐障碍患者的睡眠特征。方法纳入2019年9月至2020年6月淮安市第三人民医院门诊或住院的未治疗惊恐障碍(panic disorder,PD)患者31例为患者组,选择年龄、性别匹配的健康对照29名为对照组,利用CPC设备检测睡眠指标。结果与对照组相比,患者组的睡眠总时间[(7.84±1.41)h vs.(6.06±1.30)h]、浅睡时间[2.70(2.30,3.90)h vs.1.90(1.40,2.55)h]、快速眼动睡眠时间[(1.77±0.64)h vs.(1.13±0.44)h]、觉醒时间[0.90(0.60,1.20)h vs.0.40(0.35,0.60)h]增加,睡眠效率降低[89.20%(86.30%,93.00%)vs.92.70%(91.65%,94.25%)],差异有统计学意义(P<0.05)。logistic回归分析显示睡眠总时间(OR=0.32,95%CI:0.17~0.60)、睡眠效率(OR=1.31,95%CI:1.09~1.59)与惊恐障碍相关联。结论CPC检测显示PD患者的睡眠与健康对照存在显著差异,主要表现在睡眠总时间增加,睡眠效率降低。     

左侧颞叶癫痫患者执行功能损害与钩束弥散张量成像参数的相关性

目的 应用神经心理学方法和磁共振弥散张量成像(diffusion tensor imaging,DTI)技术研究左侧颞叶癫痫(temporal lobe epilepsy,TLE)患者执行功能损害的特点及与其双侧钩束(uncinate fasciculus,UF)DTI参数的关系.方法 对14例成人左侧TLE患者(患者组)和15名健康对照者(对照组)进行执行功能的神经心理检查(包括stroop、数字广度、数字符号、连线试验及词语流畅性)评分,并对两组受试者均进行DTI扫描.结果 患者组stroop错误数[(7.20±3.60)vs.(1.60±0.60)]高于对照组(P＜0.05),数字广度[(12.30±6.20)vs.(17.60±2.10)]、数字符号[(50.33±16.10)vs.(66.04±10.12)]及词语流畅性[(12.05±5.36) vs.(19.33±2.55)]均低于对照组(P＜0.05),stroop反应时[(23.86±10.91)vs.(16.36±6.13)]及连线试验的时间[(56.11±20.12)vs.(40.43±15.07)]均长于对照组(P＜0.05).与对照组相比,患者组左侧钩束各向异性(Fractional Anisotrophy,FA)值降低[(0.332±0.043)vs.(0.379±0.014)],差异具有统计学意义(P＜0.05).相关分析示,患者组左侧钩束FA值与词语流畅性(r=0.56,P=0.025)及数字广度(r=0.58,P=0.028)呈正相关.结论 左侧TLE患者存在广泛的执行功能损害,部分执行功能的损害与左侧钩束的损害相关,左侧钩束的损害可能是部分执行功能损害的病理生理基础.     

强迫症患者前瞻记忆缺损性质及内表型

目的考察强迫症患者前瞻记忆功能缺损情况以及强迫症患者未患病一级亲属的前瞻记忆功能,验证前瞻记忆作为强迫症内表型的潜在可能。方法选择年龄、受教育程度、性别、智商、婚姻状况相匹配的健康对照组、强迫症患者和强迫症患者一级亲属各25例,进行多试次设计的标准化前瞻记忆任务,将被试的正确反应率作为前瞻记忆功能的指标。结果强迫症患者组在基于事件的前瞻记忆和基于时间的前瞻记忆任务中正确率均低于健康对照组,差异均有统计学意义[(0.74±0.24)vs.(0.88±0.13),d=-0.140,P=0.044;(0.77±0.21)vs.(0.93±0.10),d=-0.164,P=0.011],强迫症患者一级亲属组在基于事件的前瞻记忆任务中正确率低于健康对照组,差异有统计学意义[(0.73±0.20)vs.(0.88±0.13),d=-0.144,P=0.036]。结论强迫症患者前瞻记忆缺损较广泛,且前瞻记忆可能是强迫症的一种内表型。     

以阳性、阴性症状为主的精神分裂症血清蛋白因子差异

目的探讨以阳性、阴性症状为主的精神分裂症患者血清蛋白因子浓度变化,及其与精神病性症状之间的关系。方法采用酶联免疫吸附技术(enzyme-linked immunosorbent assay,ELISA)测定46例阳性症状为主的精神分裂症患者、37例阴性症状为主的精神分裂患者和60名正常对照者血清中神经生长因子-β(nerve growth factor-β,NGF-β)、白介素-1β(interleukin-1β,IL-1β)和髓鞘碱性蛋白(myelin basic protein,MBP)的水平,使用阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评估患者精神病性症状。结果阳性症状为主的患者组和阴性症状为主的患者组NGF-β浓度低于对照组[(21.25±8.65)ng/L vs.(18.73±5.95)ng/L vs.(44.93±9.77)ng/L],而IL-1β[(61.55±21.08)ng/L vs.(79.33±25.68)ng/L vs.(24.77±8.09)ng/L]和MBP[(45.95±27.99)μg/L vs.(60.37±29.82)μg/L vs.(2.32±0.71)μg/L]浓度高于对照组,差异有统计学意义(P0.01)。阳性症状为主的患者组IL-1β、MBP浓度低于阴性症状为主的患者组,差异有统计学意义(P0.05)。阴性症状为主的患者组血清蛋白IL-1β(r=0.769,P0.001)、MBP(r=0.499,P=0.002)浓度与阴性症状分呈正相关。结论阴性症状为主与阳性症状为主的精神分裂症可能有着不同的病理学机制。     

新兵入伍军训前后抑郁症状躯体化与应激、安全感的关系

目的探讨武警士兵抑郁症状躯体化与应激、安全感的关系。方法采用方便取样方法选取某武警部队新入伍士兵353人为调查对象,采用军人心理应激自评问卷(PSET),流调中心用抑郁量表(CES-D),包括:抑郁情绪(DOA)、积极情绪(PA)、躯体症状与活动迟滞(SARA)、人际(I)4个分量表,安全感量表(SQ)在军训前后进行追踪测评。结果 CES-D高分组SARA评分高于低分组[(8.33±2.70)vs.(1.76±1.75)],军训后PSET、SARA、SQ得分高于军训前[(48.00±8.49)vs.(49.98±10.01)、(1.41±2.11)vs.(1.90±2.56)、(64.00±10.09)vs.(59.13±9.57)],差异有统计学意义(P均0.05)。武警士兵SARA-2得分与PSET-1、SARA-1、PSET-2得分之间呈正相关(r=0.276、0.378、0.679,P0.01),与SQ-1、SQ-2得分呈负相关(r=-0.265、-0.503,P0.01)。分层回归分析显示,PSET-1、PSET-2、SQ-2得分对SARA-2预测的变异量为51.5%(F=80.309,P0.05),PSET-1、PSET-2得分与SARA-2得分之间呈正相关(β=0.049、0.153,P0.05);SQ-2得分与SARA-2得分之间呈负相关(β=-0.046,P0.05)。结论抑郁症状躯体化情绪反应是武警士兵群体容易出现的个人情感反应倾向,并较容易受到环境因素影响。     

小剂量MK-801对大鼠参照记忆、空间工作记忆和逆反学习能力的影响

目的 探讨腹腔注射N-甲基-D-天冬氨酸 (NMDA )受体拮抗剂地卓西平马来酸盐(MK-801)对大鼠认知功能的影响.方法 成年雄性SD大鼠随机分为MK-801组和对照组,分别腹腔注射小剂量生理盐水或MK-801(0.1 mg/kg)20 min后在Morris水迷宫中评定MK-801对大鼠参照记忆、空间工作记忆和逆反学习能力的影响.结果 参照记忆任务中,与对照组相比MK-801组逃避潜伏期延长(P<0.05),且在目标象限的探索时间百分比[(22.7±2.9)%]与相邻象限[(24.0±0.9)%]和对立象限[(29.3±2.4)%]的差异无统计学意义 (P>0.05);空间工作记忆任务中,对照组匹配试次潜伏期显著短于样本试次[(37.6±6.0) vs (61.5±6.3),P<0.05],而MK-801组两试次潜伏期差异无统计学意义[(53.8±7.8) vs (62.2±7.1),P>0.05];逆反学习任务中,与对照组相比MK-801组潜伏期明显延长(P<0.05),且在空间探索中新旧目标象限探索时间百分比差值小于对照组[(-0.01±4.7) vs (23.5±6.2),P<0.01].结论 腹腔注射小剂量MK-801破坏了大鼠的参照记忆、空间工作记忆和逆反学习,提示其在多个认知维度上可模拟精神分裂症患者的认知缺陷.     

阿立哌唑降低利培酮所致女性精神分裂症患者体重增加及催乳素水平升高的对照研究

目的探讨合并使用阿立哌唑降低利培酮所致女性精神分裂症患者体重增加及催乳素(PRL)水平升高的效果。方法将符合入组标准的女性精神分裂症患者56例,采用数字随机法分为研究组和对照组,各28例,在原利培酮治疗的基础上,给予研究组阿立哌唑10mg/d治疗。共12周,在第0,4,8,12周末采用阳性和阴性症状量表(PANSS)和副反应量表(TESS)评定疗效及不良反应。采用体重、体重指数、腹围评定体重改善情况并用放射免疫法检测催乳素水平。结果 12周末两组PANSS总评分差异无统计学意义(P>0.05),但PANSS阴性症状评分研究组低于对照组[(16.60±4.20)vs.(24.60±5.20),(P<0.01)];12周末体重、体重指数、腹围、催乳素水平研究组均低于对照组[(54.20±9.50)vs.(58.40±9.30),(20.20±3.30)vs.(22.90±3.00),(71.50±9.30)vs.(74.20±8.70),(492.90±110.70)vs.(593.30±108.30)],8周未腹围、催乳素水平研究组也低于对照组[(73.20±8.80)vs.(74.20±9.60),(558.50±98.80)vs.(621.80±102.50)],差异有统计学意义(P均<0.05或0.01)。结论合并小剂量阿立哌唑可有效降低女性精神分裂症患者服用利培酮所致的体重增加和催乳素水平升高,且对精神分裂症的阴性症状更有效。     

4种非经典抗精神病药对精神分裂症患者心电图校正QT间期的影响

目的评估利培酮、喹硫平、奥氮平、齐拉西酮4种非经典抗精神病药对精神分裂症患者心电图校正QT间期(corrected QT interval,QTc)的影响。方法 97例精神分裂症患者随机分为利培酮组(n=25)、喹硫平组(n=23)、奥氮平组(n=28)、齐拉西酮组(n=21),口服4种药物中的单一药物治疗。治疗前连续3次心电图检查,血药浓度达稳态后(1次常规服药前30分钟、估计Tmax、Tmax后60分钟)再连续3次心电图检查,测量QT间期,以Bazett’s公式校正为QTc。计算治疗前后QTc均值并进行比较。结果与治疗前相比,治疗后4组QTc都有延长,利培酮组[(382.4±16.3)ms vs.(378.6±13.9)ms]、奥氮平组[(379.2±15.6)ms vs.(376.7±15.13)ms]、喹硫平组[(382.8±16.9)ms vs.(377.5±14.3)ms]、齐拉西酮组[(402.4±33.8)ms vs.(377.1±14.6)ms],与治疗前比较差异有统计学意义(P<0.05)。治疗后QTc各组之间比较差异有统计学意义(P<0.05),齐拉西酮组延长最明显,其中1例女性患者QTc达534 ms。结论 4种非经典抗精神病药均不同程度延长精神分裂症患者QTc。     

Ocular motor responses to unpredictable and predictable smooth pursuit stimuli among patients with obsessive-compulsive disorder.

This study was conducted to evaluate the smooth pursuit system functioning of patients with obsessive-compulsive disorder (OCD). For Study 1, 12 subjects with OCD and 12 nonpsychiatric subjects were administered 9-deg-per-sec ramp stimuli to elicit smooth pursuit eye movements. Consistent with a previous report, patients with OCD did not significantly differ from nonpsychiatric subjects on pursuit gain, or frequency of corrective and intrusive saccades. Patients with OCD, however, had smaller catch-up saccades during smooth pursuit than nonpsychiatric subjects. For Study 2, 12 subjects with OCD and 12 nonpsychiatric subjects were administered 2 different triangle wave stimuli with target velocities of 12 (0.2 Hz) deg per sec and 24 (0.4 Hz) deg per sec. Subjects with OCD and nonpsychiatric subjects did not significantly differ on any variable in the slow target velocity condition. When following 24-deg-per-sec targets, however, patients with OCD had significantly lower pursuit gain than the nonpsychiatric subjects. Results from Study 1 and 2 are consistent with the hypothesis that patients with OCD have a modest smooth pursuit deficit that is elicited only while following faster velocity targets.     

The relationship between antisaccades, smooth pursuit, and executive dysfunction in first-episode schizophrenia.

BACKGROUND: Both oculomotor and neuropsychologic deficits have been used to support the hypothesis that schizophrenia is associated with prefrontal cortex dysfunction, but studies that have specifically investigated the relationships between these deficits have produced inconsistent findings. METHODS: We measured both smooth pursuit and antisaccade performance in a large group (n = 109) of patients with first-episode schizophrenia and a group of matched control subjects (n = 59) and investigated the relationship between performance on these tasks and performance on a range of executive tasks. We additionally explored the relationship between these variables and measures of psychopathology at presentation and duration of untreated psychosis. RESULTS: Antisaccade errors were significantly correlated with spatial working memory performance. Smooth pursuit gain did not correlate with any neuropsychologic measure. There were no reliable correlations between either oculomotor variables and measures of psychopathology and duration of untreated psychosis. CONCLUSIONS: These findings suggest that in schizophrenia working memory and antisaccade performance reflect the same abnormal prefrontal substrates and that smooth pursuit is mediated by a separate neural abnormality.     

Neuropsychological and oculomotor correlates of spatial working memory performance in schizophrenia patients and controls.

Recent reports of spatial working memory deficits in schizophrenia provide evidence for dorsolateral prefrontal cortical (DLPFC) dysfunction. However, the question of how spatial working memory performance relates to other task impairments in schizophrenia considered reflective of frontal dysfunction, such as the Wisconsin Card Sorting Test (WCST) and smooth pursuit eye tracking, has been largely unexplored. Spatial working memory, as measured by a computerized visual-manual delayed response task (DRT), was evaluated in 42 schizophrenia patients and 54 normal controls. Subjects also completed a battery of neuropsychological and oculomotor tasks. Schizophrenia patients performed as accurately as controls on a no-delay, sensory-motor control condition, but showed a significant impairment in spatial accuracy with the addition of an 8-s delay and verbal distraction task. For the patients, working memory impairment was associated with fewer categories on the WCST, impaired eye tracking, fewer words learned on the Rey Auditory Verbal Learning Test, but not with measures of general cognitive and clinical functioning. Results suggest the presence of a sub-group of schizophrenia patients with common pathophysiology that accounts for the co-variance of several tasks implicating prefrontal dysfunction.     

Smooth pursuit and visual scanpaths: Independence of two candidate oculomotor risk markers for schizophrenia

Abstract

Objectives. Smooth pursuit and visual scanpath deficits are candidate trait markers for schizophrenia. It is not clear whether eye tracking dysfunction (ETD) and atypical scanpath behaviour are the product of the same underlying neurobiological processes. We have examined co-occurrence of ETD and scanpath disturbance in individuals with schizophrenia and healthy volunteers. Methods. Eye movements of individuals with schizophrenia (N = 96) and non-clinical age-matched comparison participants (N = 100) were recorded using non-invasive infrared oculography during smooth pursuit in both predictable (horizontal sinusoid) and less predictable (Lissajous sinusoid) conditions and a free viewing scanpath task. Results. Individuals with schizophrenia demonstrated scanning deficits in both tasks. There was no association between performance measures of smooth pursuit and scene scanpaths in patient or control groups. Odds ratios comparing the likelihood of scanpath dysfunction when ETD was present, and the likelihood of finding scanpath dysfunction when ETD was absent were not significant in patients or controls in either pursuit variant, suggesting that ETD and scanpath dysfunction are independent anomalies in schizophrenia. Conclusion. ETD and scanpath disturbance appear to reflect independent oculomotor or neurocognitive deficits in schizophrenia. Each task may confer unique information about the pathophysiology of psychosis.     

Ultralow vestibuloocular reflex time constants

We report detailed oculomotor studies in 3 patients with central nervous system lesions and markedly decreased time constants (less than 2 seconds) of the vestibuloocular reflex (VOR). In 1 patient with Chiari type I malformation, serial measurements over 3 years documented a progressive decrease in the duration of postrotatory nystagmus (100 deg/sec steps, acceleration 140 deg/sec2) until finally there was no sustained nystagmus. At this time, the patient had no response to caloric stimulation or to sinusoidal rotation below 0.2 Hz but normal gain (peak slow-phase eye velocity/peak chair velocity) above 0.4 Hz (phase lead increased). Gaze holding, saccades, smooth pursuit, and optokinetic nystagmus were normal, but optokinetic-after-nystagmus disappeared. The other 2 patients (combined brainstem-cerebellar atrophy) had impaired gaze holding, abnormal smooth pursuit and optokinetic nystagmus, and absent optokinetic-after-nystagmus. VOR gain to step and high-frequency sinusoidal stimuli was increased. The neural mechanism that normally prolongs the VOR time constant may have reduced it in our patients.     

Evaluation of the smooth pursuit tests in multiple sclerosis patients

In multiple sclerosis (MS), randomly located demyelination lesions may involve a large part of the central nervous system and disturb oculomotor activity, including impairment of saccadic and pursuit systems. The aim of the work was to determine the frequency of smooth pursuit disturbances in MS patients and assess the feasibility of various methods for smooth pursuit assessment: the clinical bedside examination and quantitative electrooculographic (EOG) recordings. In addition, we analyzed the effects of age on the results of smooth pursuit tests. Sixty MS patients and 50 volunteers underwent clinical bedside examination and EOG evaluation in a tertiary referral university hospital. EOG recordings of smooth pursuit tests with 0.3, 0.4, 0.5 and 15 Hz amplitude and gain calculation were preformed. In clinical bedside examination, disorders were found in 25%, and with EOG in 76.6% of patients. In the MS patients and subgroups the mean gain for all frequencies were significantly lower compared with the control group. There were significant differences in gain between younger and older subjects in the control group but no significance in all MS patients their subgroups. Patients with abnormalities in clinical bedside examination had poorer results in EOG tests. There were correlations between gain values and Expanded Disability Status Scale score in MS patients. Smooth pursuit examination provides a valuable parameter of brain dysfunction in MS patients. The EOG test is more useful in detecting subclinical cases than clinical bedside examination, and is not affected by test paradigm or age in MS patients.     

Generalized and specific neurocognitive deficits in prodromal schizophrenia.

BACKGROUND: Neurocognitive deficits are considered to be central to the pathophysiology of schizophrenia, and the neurodevelopmental model suggests that such deficits precede full-blown psychosis. The present study examined performance on a broad neuropsychological battery of young subjects considered to be at clinical high risk for schizophrenia, who were subsequently followed to determine clinical outcome. METHODS: Subjects were 38 clinical high-risk patients (58% male patients; mean age = 16.5) and 39 sex- and age-matched healthy control subjects. At baseline, all high-risk patients had attenuated (subpsychotic) schizophrenialike positive symptoms. Clinical follow-up data of at least 6 months duration was available on 33 patients, of whom 12 developed nonaffective psychotic disorders. RESULTS: At baseline, clinical high-risk patients had significantly impaired global cognitive performance relative to control subjects and to estimates of their own prior intellectual functioning. Measures of verbal memory and executive functioning/working memory showed significantly greater impairments; visuospatial functioning was relatively spared. Prodromal patients who later developed psychosis had significantly lower verbal memory scores at baseline compared with patients who remained nonpsychotic. CONCLUSIONS: Verbal memory deficits may be an important risk marker for the development of schizophrenia-spectrum psychotic disorders, possibly indicating the presence of a prefrontal-hippocampal neurodevelopmental abnormality. Generalized neurocognitive impairment may be a nonspecific vulnerability marker.     

功能磁共振成像研究睡眠剥夺36小时对健康男性工作记忆的影响

目的 利用功能磁共振成像(functional magnetic resonance imaging,fMRI)技术研究睡眠剥夺36 h对健康男性工作记忆的影响及可能机制.方法 10名健康男性受试者连续36 h睡眠剥夺,睡眠剥夺前后分别接受工作记忆任务测试,同时进行fMRI扫描.fMRI扫描采用2项工作记忆任务,收集获得的行为学结果和fMRI图像,用SPM2软件进行图像分析.比较睡眠剥夺前后工作记忆任务测试及fMRI扫描结果.结果 剥夺后LTR任务的反应时间为(866±102)ms,比剥夺前[(754±91)ms]明显延长(t=2.59,P<0.01),准确率为84.78%±8.71%,比剥夺前(95.31%±3.56%)明显降低(t=3.52,P<0.01);剥夺后PLUS任务的反应时间为(848±94)ms,比剥夺前[(756±79),ms]明显延长(t=2.37,P<0.05),准确率为84.22%±9.66%,比剥夺前(95.70%±4.72%)明显降低(t=3.38,P<0.01);剥夺前在额顶叶、前扣带回和丘脑等工作记忆相关性脑区被激活.PLUS任务较LTR任务激活脑区范围更广,强度更显著.剥夺后顶叶激活降低,前额叶和丘脑的激活增强.结论 睡眠剥夺能够导致工作记忆能力受损.fMRI显示睡眠剥夺后完成工作记忆任务时,在相应脑区顶叶激活降低,前额叶和丘脑激活增强,这可能是睡眠剥夺导致认知功能损害的机制之一.     

A longitudinal study of neurocognitive function in individuals at-risk for psychosis

INTRODUCTION: Clinically defined prodromal diagnostic criteria identify at-risk individuals with a 35-40% likelihood of developing a psychotic disorder within a year. The time course and predictive value of cognitive deficits in the development of psychosis has not been established. METHODS: A comprehensive neurocognitive battery and clinical assessments were administered to 37 subjects meeting Criteria of Prodromal States (COPS) criteria for being at risk for psychosis, and two comparison groups: 59 first episode and 47 healthy subjects. Subjects were also evaluated at 6-month and 1-year follow-up periods. Primary analyses used a neurocognitive composite score derived from individual neurocognitive measures, including measures of vigilance, verbal memory, working memory, and processing speed. RESULTS: At-risk subjects performed more poorly than healthy subjects (t=2.93, P=0.01), but better than first episode subjects (t=4.72, p<0.0001). At-risk subjects were particularly impaired on measures of vigilance and processing speed. Cognitive composite scores were significantly lower in at-risk subjects who progressed to psychosis (N=11; z=-1.2), while those at-risk subjects who did not progress to psychosis (N=17) performed better (z=-0.5), and not significantly different from controls. Poor CPT performance combined with better WAIS-R digit symbol performance predicted progression to psychosis. Severity of neurocognitive deficits was not related to duration of prodrome or to time to development of psychosis and neurocognitive function improved in all subjects except those who progressed to psychosis. CONCLUSION: Neurocognitive impairment emerges early in the course of psychotic illness. Performance on tests of neurocognition may prove to be an early risk predictor for subsequent development of psychotic disorders.     

Abnormalities of smooth eye and head movement control in parhson's disease

The control of horizontal head and eye movements was examined in 13 nondemented patients with Parkinson's disease (PD) of mild to moderate severity. During pursuit of single-frequency sine waves, smooth component eye velocity was lower in the PD group at frequencies of 1.2 Hz and above; but the differences in overall eye displacement were even greater, indicating an impaired ability to generate catch-up saccades at high frequencies. A corresponding deficit in saccadic performance was observed during a high-frequency saccadic tracking task where predictive saccades of reduced gain and variable timing were generated. During pursuit of pseudo-random target motion with varying degrees of predictability, small differences in smooth component eye velocity were observed, but prediction was otherwise well preserved in the patient group. Vestibulo-ocular reflex (VOR) suppression was also normal during head-free pursuit. No major improvement in smooth pursuit gain could be attributed to drug treatment, based on a comparison of patient results before and after administration of levodopa.