焦虑症患者感觉门控的研究

目的 了解焦虑症的听觉诱发电位P50特点.方法 应用美国Nicolet Bravo脑电生理仪,采用听觉条件刺激(S1)-测试刺激(S2)模式对36例焦虑症患者和45名正常人作了听觉P50检测.结果 (1)焦虑症P50抑制明显减弱;S2-P50波幅正常人(2.2±0.9)μV,患者组(2.8±1.8)μV,P<0.05.(2)与正常对照组相比,焦虑症组S1-P50降低(S1-P50正常组(5.2±3.1) μV,患者组(3.9±1.2)μV,P<0.05).(3)P50抑制明显减弱,即S1-S2比值明显降低(正常组3.0±1.9,患者组1.1±2.4,P<0.01).结论 焦虑症的感觉门同样也存在异常,表现为抑制不足,能通过听觉P50进行定量检测.     

精神分裂症首次发病患者和健康成年人听觉感觉门控电位P50的研究

目的探讨精神分裂症首次发病(以下简称首发)患者和健康成年人听觉感觉门控电位P50的特点。方法采用听觉条件(S1)测-试刺激(S2)范式对58例首发精神分裂症患者(患者组)和108名健康成年人(正常对照组)进行P50检测,评定阳性和阴性症状量表(PANSS)。结果(1)在Cz、Fz和Pz脑区,正常对照组S1所诱发的P50波(S1-P50)潜伏期与S2所诱发的P50波(S2-P50)潜伏期的差异无统计学意义(P>0.05);S2-P50波幅[分别为(2.2±1.4)μV,(2.3±1.5)μV,(2.1±1.4)μV]低于S1-P50波幅[分别为(5.6±3.3)μV,(5.6±3.9)μV,(4.9±2.8)μV;P<0.01];S2/S1比值、S1-S2差值和100(1-S2/S1)的差异无统计学意义(P>0.05)。(2)与正常对照组比较,患者组在Cz、Fz和Pz脑区的S1-P50波幅低(Pz:Z=-2.030,P=0.042,余P<0.01),S2-P50波幅高;S2/S1比值高,S1-S2差值小,100(1-S2/S1)值低(P均<0.01)。(3)患者组的S2/S1比值、S1-S2差值和100(1-S2/S1)值与PANSS总分[(138.49±15.30)分]无相关性(P>0.05)。结论首发精神分裂症患者的感觉门控功能有异常,能通过感觉门控电位P50定量表达。     

首发强迫症感觉门控变异及与临床症状的相关性

目的:了解首发强迫症(OCD)患者的听觉P50变异特点,探讨感觉门控抑制与强迫症状的关系。方法:应用美国Nicolet Bravo脑诱发电位仪,采用听觉条件刺激(S1)-测试刺激(S2)模式对42例OCD患者和46名正常志愿者进行听觉P50检测;应用Yale-Brown强迫量表进行临床症状评定。结果:与正常组相比,强迫症组S2-P50波幅升高(P<0.05),S1-S2和100(1-S2/S1)均降低,差异有统计学意义(P均<0.01)。经Pearson相关分析,Yale-Brown强迫量表评分强迫思维因子分与S2-P50波幅呈正相关(P<0.05),与100(1-S2/S1)呈负相关(P<0.05)。结论:首发强迫症患者的感觉门控变异特点为抑制不足,强迫思维与感觉门控抑制程度有一定的相关性。     

伴有凶杀行为精神分裂症患者听觉感觉门控P50的随访研究

目的 随访分析伴有凶杀行为的精神分裂症患者听觉感觉门控电位P50的变化.方法 采用条件-测试刺激模式,对25例伴有凶杀行为的精神分裂症患者(患者组)和27名正常对照者(对照组)进行P50检测和比较,经过抗精神病药物治疗3个月后,有11例患者完成了P50随访,同时应用阳性和阴性症状量表(PANSS)评定患者的精神症状.结果 ①与对照组相比,患者组在入组未用药时和随访3个月时的S2-P50波幅均较高(P<0.01),S2/S1比值均较大(P<0.01),S1-S2差值(P<0.05)和100(1-S2/S1)值均较小(P<0.01).患者组P50波幅、潜伏期和P50抑制指标在入组时和3个月时的差异均无统计学意义(P>0.05).②与入组时相比,3个月时患者组PANSS总分、阳性量表分、一般精神病理量表分以及反应缺乏、思维障碍、激活性、偏执、抑郁、攻击等6个症状群得分降低(P<0.05).③患者组在入组时和3个月时S2/S1比值、S1-S2差值和100(1-S2/S1)等P50抑制指标与病程、PANSS各指标均无相关(P>0.05).结论 伴有凶杀行为的精神分裂症患者感觉门控存在异常,且P50抑制指标可能是该人群的素质指标.     

卒中后抑郁患者感觉门控P50的变化探讨

目的探讨卒中后抑郁患者的听觉诱发电位P50的变化。方法应用脑电生理仪,采用条件刺激(S1)-试验刺激(S2)双声刺激模式记录听觉P50诱发电位,比较卒中后抑郁患者和正常人听觉P50诱发电位的差异。结果实验组S2-P50波幅显著高于正常组S2-P50波幅(2.09±1.05)(P<0.05);实验组P50抑制减弱,S2/S1比值(0.81±0.35)与正常组(0.37±0.23)比较显著增高(P<0.05);实验组S2-S1波幅的差(1.59±0.71)与正常组(4.85±2.24)比较显著减小(P<0.01)。结论卒中后抑郁患者存在感觉门控P50的异常,感觉门控P50可能成为对于卒中后抑郁评价的一种方法。     

30名健康儿童的感觉门控P50研究

目的 应用诱发电位新技术探讨健康儿童感觉门控 (SG) P50特点.方法 应用美国Nicolet脑电生理仪,采用条件刺激(S1)-测试刺激(S2)模式对30名健康儿童进行听觉P50检测.结果 健康儿童Cz脑区S1-P50潜伏期(60.7±11.9)ms,波幅(5.7±3.3)μV;S2-P50潜伏期(65.4±22.0)ms,波幅(2.4±1.3)μV.S2-P50波幅显著低于S1-P50(P<0.01).S2/S1比值为(42.8±21.0)%;S1-S2波幅和100(1-S2/S1)波幅分别为(3.3±2.6)μV和(57.9±21.0)μV.结论 听觉P50电位具有抑制性特征,其变化可反映大脑健康儿童SG的功能状态.     

孤独症患儿感觉抑制P50试验研究

目的 了解孤独症患儿感觉门控 (SG)抑制P50的特点.方法 应用美国Nicolet Bravo脑电生理仪,采用听觉条件刺激(S1)-测试刺激(S2)模式对37例孤独症患儿和30名正常儿童作了听觉P50检测.结果 孤独症组P50抑制明显减弱;S2-P50波幅增加[正常对照组 (2.5±2.0)μV,孤独症组(4.9±3.1) μV,P<0.01].与正常对照组相比,孤独症组S1-P50降低 [正常对照组(5.7±3.7)μV,孤独症组(3.0±2.4)μV,P<0.01].P50抑制明显减弱,即S1-S2比值明显降低 [正常对照组(3.9±2.7) μV,孤独症组(1.5±1.1) μV,P<0.01].结论 孤独症的SG亦存在异常,表现为抑制不足.     

精神分裂症首次发病患者治疗前后感觉门控功能的动态观察

目的探讨精神分裂症首次发病(以下简称首发)患者治疗前后的听觉诱发电位P50变异的意义。方法应用美国Bravo脑电生理仪,采用条件刺激(S1)-测试刺激(S2)模式,分别于治疗前(66例)、治疗第5周(42例)和第12周(32例)对首发精神分裂症患者(患者组)进行P50检测,同时用阳性和阴性症状量表(PANSS)评定患者的临床症状;并以正常人(对照组,92名)的P50做比较。结果(1)治疗前,患者组的S1-P50波幅[(3±2)μV]低于对照组[(6±3)μV],S2-P50波幅[(4±2)μV]高于对照组[(2±1)μV],均P<0.01;患者组S2/S1比值[(81±40)%]高于对照组[(42±21)%],S1-S2波幅[(2±1)μV]低于对照组[(3±2)μV],100(1-S2/S1)值(19±17)低于对照组(58±21),差异均有统计学意义(P<0.05~0.01)。(2)患者组的S2/S1、S1-S2和100(1-S2/S1)与PANSS评分无相关性(P>0.05)。(3)与治疗前比较,患者组在治疗第5周末及第12周末P50的各项指标均无明显改变(均P>0.05)。结论P50变异可能是精神分裂症患者的早期改变,具有一定的属性标志特性,值得进一步随访研究。     

健康成人感觉门抑制P50实验研究

目的 应用脑诱发电位新技术探讨健康成人听觉P50特点.方法 应用美国Nicolet Bravo脑电生理仪,采用条件刺激(S1)-测试刺激(S2)模式对58名健康成人作了听觉P50检测.结果 S1-P50潜伏期和波幅与S2-P50潜伏期和波幅在三个脑区无统计学差异.Cz脑区显示,健康成人S1-P50潜伏期(59.6±11.1)ms,波幅(6.1±3.3)μV;S2-P50潜伏期(68.7±24.6)ms,波幅(1.9±1.3)μV.S2-P50波幅显著低于S1-P50波幅(t=9.02,P<0.01).P50潜伏期和波幅无性别差异.结论 听觉P50电位具有抑制性特点,其变化可反映大脑正常感觉门抑制的功能状态.     

首次发病的精神分裂症患者感觉门控P50特征及其相关因素

目的:探讨首次发病的精神分裂症患者感觉门控P50特征及其相关临床因素。方法:给予87例首发未服药的精神分裂症住院患者(患者组)单一利培酮(4~6 mg/d)治疗,疗程10周;治疗前后分别进行阳性和阴性综合征量表(PANSS)评定及P50检测;以PANSS减分率50%分割点将患者分为有效组和无效组;P50检测结果与86名健康志愿者(对照组)比较;分析患者组P50指标与临床因素的关系。结果:患者组治疗前P50听觉条件(S1)、测试刺激(S2)潜伏期显著长于对照组,S1波幅及S1-S2波幅差值显著低于对照组,S2/S1显著高于对照组(P均0.01);治疗后S1、S2波幅较治疗前显著下降(P均0.01);有效组与无效组间P50各项指标差异无统计学意义;治疗前S2波幅与PANSS阳性症状分呈正相关;S1-S2波幅差值与病程、PANSS中一般精神病理分呈负相关;S2波幅/S1波幅与病程、PANSS总分及一般精神病理分正相关(P均0.05)。结论:首发精神分裂症患者P50抑制缺陷;其与患者的病程、精神病理症状相关;利培酮治疗对P50 S1、S2波幅有影响,但可能未改善其抑制缺陷。     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.