威斯康星卡片分类测验用于注意缺陷多动障碍的meta分析

目的　分析注意缺陷多动障碍 (ADHD)患儿与正常儿童在威斯康星卡片分类测验 (WCST)中各指标成绩的差异。方法　复习国外 14篇有关文献 ,对ADHD患儿和正常儿童WCST的 4个指标 (持续性错误数、分类完成数、非持续性错误数和持续性反应数 )进行meta分析。结果　ADHD和正常对照组在WCST的持续性错误数、完成分类数和非持续性错误数的成绩差异有统计学意义 ,且可靠性较好。两组的持续性反应数也有统计学意义 ,但其可靠性较差。ADHD患儿的平均持续错误数比正常儿童高 0 4 6倍标准差。正常儿童的平均完成分类数比ADHD组高 0 37倍标准差。ADHD患儿的平均非持续性错误数比正常儿童高 0 37倍标准差。ADHD患儿的平均持续性反应数比正常儿童高 0 30倍标准差。 4个指标的效应尺度均在小至中的范围。结论　WCST值得推广应用于ADHD患儿 ,较敏感的指标包括持续性错误数、完成分类数和非持续性错误数。ADHD患儿可能存在前额叶功能缺陷。     

缓解期双相情感障碍I型II型患者及近亲属认知功能对照研究

目的：探讨缓解期双相情感障碍I型、II型患者及其近亲属认知功能的临床特征。方法对50例缓解期双相障碍I型患者（BP‐1组）、50例缓解期双相障碍II型患者（BP‐2组）、50名健康近亲属（亲属组）及50名正常人群（对照组）采用持续操作测验和威斯康星卡片分类测验进行测评分析。结果 BP‐1组、BP‐2组及亲属组持续操作测验的正确数评分显著低于对照组（P＜0．05）,且BP‐1组显著低于BP‐2组和亲属组（P＜0．05）。BP‐1组、BP‐2组和亲属组威斯康星卡片分类测验的错误应答数、非持续性错误数显著高于对照组（P＜0．05或0．01）;BP‐1组、亲属组显著高于BP‐2组（P＜0．01）;BP‐1组和亲属组总应答数、完成分类数、正确率、完成第一个分类数所需要应答数、不能维持完整分类数与对照组及BP‐2组比较差异有显著性（P＜0．05或0．01）。结论缓解期双相情感障碍I型、II型患者及其近亲属存在多维度认知功能损害,I型患者任务管理能力损害较明显,II型患者注意力损害明显。     

Advance preparation and stimulus-induced interference in cued task switching: further insights from BOLD fMRI

To switch from one cognitive task to another is thought to rely on additional control effort being indicated by performance costs relative to repeating the same task. This switch cost can be reduced by advance task preparation. In the present experiment the nature of advance preparation was investigated by comparing a situation where an explicit task cue was presented 2000 ms in advance of the target stimulus (CTI-2000) with a situation where cue and target were presented in close succession (CTI-100). We mapped the blood-oxygenation-level-dependent (BOLD) activation correlates of switch-related control effort and advance task preparation to test alternative explanations why advance preparation is reducing switch costs. A previously reported control-related cortical network of frontal and parietal brain areas emerged that was more strongly activated for switching between tasks. However, this was true exclusively for CTI-100 where no advance task preparation was possible. At CTI-2000 these same brain areas were equally engaged in both switch and repeat trials. For some of these areas, this common activation was time-locked to the presentation of both the cue as well as the target. Other areas were exclusively associated with target processing. The overall pattern of results suggests that advance task preparation is a common process of pre-activating (cue-locked activation) the currently relevant task set which does not face interference from a persisting N - 1 task set. During target processing the same brain areas are re-engaged (subsequent target-locked activation) to apply the pre-activated task set. Though being common to repeat and switch trials, advance preparation has a differential benefit for switch trials. This is because the instructed task set has time to settle into a stable state, thus becoming resistant against disruption from the previous task set, which is retrieved by the current target stimulus.     

Cannabis induces different cognitive changes in schizophrenic patients and in healthy controls

It is known that 60 to 80% of schizophrenic patients show deficits in cognition. There may be an increase in these deficits as a result of additional regular use of cannabis. The aim of the study was to evaluate the effect of chronic cannabis consumption on the cognitive functions of schizophrenic patients and healthy control subjects after a minimum abstinence time of 28 days. The study sample consisted of 39 schizophrenics (19 cannabis-abusers and 20 non-abusers) and 39 healthy controls (18 cannabis-abusers, 21 non-abusers). In a 2x2-factorial design (Diagnostic Groups [healthy controls, schizophrenic patients]xCannabis abuse [without, with]) with diagnostic group and cannabis consumption considered between-subject factors) we tested the hypothesis that dually diagnosed patients (i.e. suffering both from schizophrenia and cannabis abuse) perform worse in neuropsychological tests than schizophrenic patients without cannabis abuse. On the whole, schizophrenic patients performed worse than healthy control subjects. Surprisingly, rather than deteriorating neuropsychological performance, regular cannabis abuse prior to the first psychotic episode improved cognition in some tests. This was even more pronounced when regular consumption started before the age of 17. On the other hand, cannabis use deteriorated test performance in healthy controls, especially in cases when regular consumption started before the age of 17. To sum up, regular cannabis abuse has a different effect on cognitive function in schizophrenic patients and healthy controls.     

Cognitive dysfunctions in patients with obsessive-compulsive disorder compared to the patients with schizophrenia patients: relation to overvalued ideas

OBJECTIVE: The clinical overlaps between schizophrenia and obsessive-compulsive disorder (OCD) seem to be related to thought disorders involving obsessions, overvalued ideas, and delusions. Overvalued ideas are beliefs falling in between obsessions and delusions and are stronger than obsessions but weaker than delusions. The goal of the present study was to compare patients with OCD to those with schizophrenia in terms of cognitive functions and to relate cognition and overvalued ideas in OCD. METHODS: Twenty three patients with OCD (free of depression), 24 patients with schizophrenia, and 22 healthy subjects matched to patients in age, gender, education, and hand dominance were included in the study. All subjects were administered neurocognitive tests assessing verbal learning-memory, executive functions, verbal fluency, attention and verbal working memory. RESULTS: Patients with schizophrenia showed worse performance on cognitive tests than the OCD and control groups. The severity of overvalued ideas was significantly correlated to cognitive functions in the OCD group. There were no significant differences in cognitive functions between schizophrenia group and the OCD patients who had higher scores on the Overvalued Ideas Scale (OVIS). CONCLUSION: Overvalued ideas in OCD may be related to cognitive dysfunctions in OCD and this subtype of OCD may have similar characteristics to schizophrenia in terms of cognition.     

阿立哌唑对晚发性精神分裂症患者认知功能的影响

目的 探讨阿立哌唑对晚发性精神分裂症患者认知功能的影响.方法 将106例晚发性精神分裂症患者随机分为两组,每组53例,分别口服阿立哌唑、氯丙嗪治疗.观察8周.于治疗前后采用阳性与阴性症状量表、威斯康星卡片分类测验评定临床疗效及认知功能.结果 治疗后两组阳性与阴性症状量表评分均较治疗前显著降低（P＜0.01）,阿立哌唑组威斯康星卡片分类测验的总正确数、持续反应数、完成分类数均较治疗前显著升高（P＜0.01）,总错误数、持续错误数均较治疗前显著降低（P＜0.01）,氯丙嗪组仅持续反应数较治疗前显著升高（P＜0.01）.结论 阿立哌唑治疗晚发性精神分裂症疗效显著,能显著改善患者认知功能.     

奥氮平与氯丙嗪对精神分裂症患者认知功能的影响

目的：比较奥氮平与氯丙嗪对精神分裂症患者认知功能的影响。方法将96例精神分裂症患者随机分为奥氮平组和氯丙嗪组,每组48例,分别口服奥氮平和氯丙嗪治疗,观察8周。于治疗前后采用威斯康星卡片分类测验、韦氏记忆测验及河内塔测验对两组患者的认知功能进行测评分析。结果治疗8周末,奥氮平组威斯康星卡片分类测验完成分类数、正确应答数、概念化水平百分数及持续性应答数和韦氏记忆测验评分均较治疗前显著升高（P＜0．01）,奥氮平组显著高于氯丙嗪组（ P＜0．05或0．01）;两组持续性错误数和河内塔测验的完成时间和移动次数均较治疗前显著降低（P＜0．01）,奥氮平组显著低于氯丙嗪组（P＜0．01）。结论奥氮平能显著改善精神分裂症患者的认知功能,优于氯丙嗪。     

Frontal brain activation during the Wisconsin Card Sorting Test assessed with two-channel near-infrared spectroscopy

Near-infrared spectroscopy (NIRS) is a new non-invasive optical technique suitable to assess the concentration changes of oxygenated (O₂HB) and deoxygenated (HHB) hemoglobin in brain tissue. Previous NIRS studies showed distinct patterns of blood oxygenation changes during different cognitive tasks. In particular, bilateral frontal hypo-oxygenation was found during reading, right frontal hyper-oxygenation during the Continuous Performance Test, and left frontal hyper-oxygenation during the Verbal Fluency Test. The Wisconsin Card Sorting Test (WCST) is a neuropsychological test which is presumed to activate prevalently the frontal lobes. This was demonstrated by lesion studies and functional imaging (single photon emission computed tomography and positron emission tomography). In the present study, a two-channel NIRS system was applied to investigate frontal brain areas of ten healthy subjects during performance of the WCST. A significant bilateral increase of O₂HB in frontal brain regions without hemispheric differences was found during the WCST compared with a baseline at rest. This result indicates an enhanced perfusion of the frontal lobes consistent with local activation. The findings add further evidence that the NIRS technique is sensitive enough to detect physiological blood oxygenation changes. Furthermore, a comparison with previous studies revealed an activation pattern distinct from those observed during other cognitive tasks. It is concluded that the results reflect local responses to specific task demands of the WCST. Received: 3 August 1997 / Accepted: 7 July 1998     

神经心理测定和事件相关电位P300对躯体化障碍认知功能的评价作用研究

目的探讨神经心理测定和事件相关电位P 300对躯体化障碍认知功能的评价作用。方法对56例躯体化障碍患者和50名正常对照者进行神经心理和事件相关电位P 300测定,将所得结果进行分析。结果①躯体化障碍组与正常对照组相比,事件相关电位成分中N 2、P 3波潜伏期延长,N 2、P 3波幅降低,差异有统计学性意义(P<0.01);②躯体化障碍组在领悟、数字广度、词汇、编码、填图、图片排列因子方面都比正常对照组明显的差,差异有显著性(P<0.05或P<0.01),躯体化障碍组在W CST总测验次数、持续错误数明显多于正常对照组(P<0.05);③N 2潜伏期与领悟、编码、填图、W CST持续错误数均呈负相关(P<0.05),P 3潜伏期与领悟、编码、填图、W CST持续错误数有相关性(P<0.05),P 3波幅与领悟、编码、持续错误数有相关性(P<0.05或P<0.01)。结论事件相关电位P 300能较好地反映躯体化障碍的认知功能,可以作为躯体化障碍的1项客观电生理参考指标用于临床。