精神分裂症症状特征与探究性眼球运动的关系

目的:研究精神分裂症症状特征与探究性眼球运动之间的关系。方法:应用眼球轨迹运动标记记录仪(MODEL IV,日本提供)测试60例精神分裂症患者和30例正常对照,用阳性和阴性症状量表(PANSS)评定患者的精神症状,并对PANSS五因子(阳性因子、阴性因子、兴奋因子、抑郁因子、认知因子)、阴性症状、阳性症状与探究性眼球运动进行相关分析。结果:患者组探究性眼球运动各指标评定结果均小于正常对照组(t=3．22-8．46,P<0．01)。认知探究分(CSS)、反应性探究分(RSS)与PANSS阴性症状呈负相关(均为r=-0．256,P=0．048),与PANSS认知因子呈负相关(r=-0．331、-0．427,P< 0．01)。结论:PANSS认知因子可能是精神分裂症探究性眼球运动障碍这一生物学标记的外显症状。     

精神分裂症症状与威斯康星卡片分类测验成绩的相关性

目的:探讨发作期的精神分裂症患者症状与威斯康星卡片分类测验成绩的相关性.方法:对新近发作、一月内未服用精神药物的精神分裂症40例住院患者和32例正常人进行了威斯康星卡片分类测验(WCST).用阳性和阴性症状量表(PANSS)对精神病患者进行评定,并对阳性、阴性和解体症状因子和威斯康星卡片分类测验结果作相关分析.结果:精神分裂症患者WCST操作较正常人差,差异有显著性(P＜0.05).阴性症状因子和解体症状因子与WCST操作存在相关性,阳性症状因子与WCST操作不相关.结论:精神分裂症患者在执行功能和概念化水平方面存在缺陷,其中解体和阴性症状可能与额叶功能障碍相关,前者相关性可能更大.     

精神分裂症患者面孔知觉的功能磁共振成像

目的:探讨未服药的精神分裂症患者和健康对照者面孔知觉的脑区激活的差异。方法:本研究对10名未服药的精神分裂症患者(患者组)和10名年龄、教育程度和性别匹配的健康人(对照组)进行面孔知觉测试,应用功能磁共振成像(fMRI)技术,比较两组脑区激活区域的差异。结果:两组的面孔知觉任务平均反应时差异无显著性(1.32±0.29/1.28±0.18),但患者组的正确率低于对照组(47.9±24.4/71.3±14.9,t=2.62,P<0.05)。与对照组相比,患者组在面孔知觉时双侧梭状回、左丘脑部位激活降低。结论:精神分裂症患者双侧梭状回、左丘脑功能低下,是其面孔知觉功能受损的影像学证据。     

对酒依赖者的注意-操作能力测试

目的:了解酒依赖患者注意损害情况及其相关因素.方法:对39例酒依赖患者在入院时、入院治疗六周后及45例正常人进行了连续操作试验(CPT)测试,并对测试结果进行回归分析.结果:酒依赖者的所有CPT指标均高于正常对照组,入院治疗六周后有所好转,但仍比正常人高,入院时CPT结果与血液乙醇浓度、年龄及饮酒年限有关.结论:酒依赖者注意损害广泛而严重,注意损害与饮酒有关.     

社会技能训练对慢性精神分裂症疗效的对照研究

目的:探讨社会技能训练对慢性精神分裂症阳性症状、阴性症状及认知功能的疗效.方法:将100例慢性精神分裂症患者随机分为训练组(50例)和对照组(50例).对训练组按照Liberman RP编写的<社会独立生活技能>训练程式进行训练,共12周.用BPRS、SANS、SDSI和WCST进行评定.结果:(1)训练组BPRS在总分和焦虑抑郁及缺乏活力因子分低于对照组,差异有显著性(P<0.05).(2)接受12周社交技能训练后,训练组的SANS量表全部五个因子和总分低于对照组,均有显著差异(P<0.05).(3)训练组和对照组在WCST的5个指标,差异有显著性(P<0.05).(4)SDSI评定结果表明,训练后明显降低,差异有显著性(P<0.05).结论:社会技能训练能够改善慢性精神分裂症的阳性症状、阴性症状及认知功能.     

精神分裂症病人大脑两半球功能整合的实验研究

目的：检查精神分裂症患者可能存在的大脑两半球功能整合缺陷。方法：对20名精神分裂症患者和20名正常对照者进行不同复杂度汉字“同-异”判断的半视野速示实验。结果：①“同”判断的正确反应时（895．4毫秒）显著长于“异”判断（767．0毫秒）（F=87．44，P〈0．001），“同”判断的正确反应百分数（62．70）也显著低于“异”判断（95．30）（F=74．32，P〈0．001），表明“同”判断明显难于“异”判断；②患者和正常者一样，“异”判断的正确反应时和正确反应百分数在左视野（右半球）呈现、右视野（左半球）呈现和两视野（两半球）同时呈现三种条件之问均未出现显著差异；③正常人的“同”判断在两视野（两半球）同时呈现条件的正确反应时（674．8～743．4毫秒）明显快于左视野（右半球）（795．4—820．5毫秒）（t=2．89～4．57，均P〈0．001）和右视野（左半球）（798．6—857．1毫秒）（t=2．99—4．51，均P〈0．001），而病人没有出现两视野（两半球）对“同”判断的这种优势效应；④两视野（两半球）同时呈现条件下正常人“同”判断的正确反应百分数（88．3～89．5）与“异”判断（94．5—95．4）没有显著差异，而病人“同”判断的正确反应百分数（69．4—74．1）仍明显低于“异”判断（94．4—96．5）（t=2．39—2．60，均P〈0．05）。结论：精神分裂症患者仅在相对较难的“同”判断任务加工中表现出大脑两半球的功能整合缺陷。     

103例强迫症患者探究性眼球轨迹运动分析

探究性眼球轨迹运动异常是对精神分裂症一种敏感性较强的辅助检查工具，同样，在精神分裂症谱系障碍者异常率也明显高于正常人。国外有研究报告强迫症患者存在眼球平稳跟踪运动异常，国内报告某些非典型强迫症患者与精神分裂症强迫型患者都存在探究性眼球轨迹运动异常。本文对103例临床症状典型的强迫症患者进行了探究性眼球轨迹运动检查。     

Wisconsin Card Sorting Test with children: a meta-analytic study of sensitivity and specificity

More and more frequently the presence of executive function deficits appears in the research literature in conjunction with disabilities that affect children. Research has been most directed at the extent to which executive function deficits may be implicated in specific disorders such as attention deficit hyperactivity disorder (ADHD); however, deficits in executive function have been found to be typical of developmental disorders in general. The focus of this paper is to examine the extent to which one frequently used measure of executive function, the Wisconsin Card Sorting Test (WCST), demonstrates sensitivity and specificity for the identification of those executive function deficits associated with ADHD as well as its use with other developmental disorders through meta-analytic methods. Evidence of sensitivity of the WCST to dysfunction of the central nervous system is reviewed. Effect sizes calculated for all studies compared groups of children on differing variables of the WCST. The results of this meta-analysis suggest that across all of the studies, individuals with ADHD fairly consistently exhibit poorer performance as compared to individuals without clinical diagnoses on the WCST as measured by Percent Correct, Number of Categories, Total Errors, and Perseverative Errors. Notably, other various clinical groups performed more poorly than the ADHD groups in a number of studies. Thus, while impaired performance on the WCST may be indicative of an underlying neurological disorder, most likely related to frontal lobe function, poor performance is not sufficient for a diagnosis of ADHD. Implications for further research are presented.     

Eye tracking dysfunction is a putative phenotypic susceptibility marker of schizophrenia and maps to a locus on chromosome 6p in families with multiple occurrence of the disease

The difficulties in defining the borders of the schizophrenia spectrum is one major source of variance in linkage studies of schizophrenia. The employment of biological markers may prove advantageous. Due to empirical evidence, eye tracking dysfunction (ETD) has been discussed to be the most promising marker for genetic liability to schizophrenia. With respect to the recent progress in genomic scans, which have pointed to the short arm of chromosome 6, we carried out a scan of the 6p21–23 region with 16 microsatellite markers to test for linkage between chromosomal markers and ETD as well as schizophrenia. We tested 5 models of inheritance of ETD and found maximum two-point lod scores of 3.51 for D6S271 and 3.44 for D6S282. By including these markers in a multipoint analysis, a lod score of 4.02 was obtained. In the case of schizophrenia, 7 models were tested; however, with non-significant results. Our findings, together with another recent linkage report, point to the possibility of a second susceptibility locus for schizophrenia which may be located centromeric to the HLA region. Also, the evidence of ETD being a susceptibility marker for schizophrenia receives further support.     

Association study of schizophrenia with dopamine D3 receptor gene polymorphisms: Probable effects of family history of schizophrenia?

Using a case-control design, a reported association of schizophrenia with homozygosity at the dopamine D3 receptor gene locus was investigated in a group of patients (n = 53), with schizophrenia (DSM-III-R), and psychiatrically normal controls (n = 61), matched for ethnicity and area of residence. No significant differences in the distribution of alleles or genotypes between the two groups could be deteched. However, among patients with a family history of schizophrenia, as compared to controls without such family history, an association with allele 1 at this locus was noted (Odds ratio 12.4, C.I. 1.61, 96.35). © 1993 Wiley-Liss, Inc.     

CHRNA4 was associated with prepulse inhibition of schizophrenia in Chinese: a pilot study

Introduction: Prepulse inhibition (PPI) of the auditory startle reflex, as an operational measurement used to evaluate the function of brain sensorimotor gating, appears to be a sensitive potential endophenotype for schizophrenia. CHRNA4 is highly expressed in the central nervous system and has been demonstrated to be significantly associated with schizophrenia by previous studies. The purpose of the current study was to evaluate the effect of CHRNA4 on PPI and acoustic startle parameters in schizophrenia.

Methods: 77 patients with schizophrenia and 62 controls were administered the test PPI, and 3 single nucleotide polymorphisms (SNPs) (rs3746372, rs1044396, and rs3787140) of CHRNA4 were genotyped in these subjects.

Results: Patients with schizophrenia showed significantly lower levels of PPI at the 120?ms prepulse intervals and longer peak latency than controls, and the GG genotype of rs3746372 and the TT genotype of rs1044396 were associated with decreased PPI levels in schizophrenia but not in controls.

Conclusion: PPI may be influenced by the polymorphisms of the CHRNA4 in schizophrenia and it may be a potential endophenotype of schizophrenia. An independent replication would greatly increase the value of this study.     

A novel virtual reality-based theory of mind intervention for outpatients with schizophrenia: A proof-of-concept pilot study

Schizophrenia is a severe and highly disabling mental illness. Although several pharmacological solutions are available to alleviate symptoms of schizophrenia, they do not seem to provide solution for accompanying social dysfunctions. To handle this unmet clinical need, many innovative interventions have been developed recently. Considering the promising results on this field and the development trend, characterized by the growing proportion of included interactive technology, our research team developed a novel virtual reality (VR)-based targeted theory of mind (ToM) intervention (VR-ToMIS) for stable outpatients with schizophrenia. VR-ToMIS is a nine-session long structured and individualized method that uses cognitive and behavioural therapeutic techniques in an immersive VR environment. Our study was a randomized, controlled pilot study. Twenty-one patients have been recruited and randomly allocated to either VR-ToMIS or passive VR condition. Patients assigned to passive VR condition could use the same VR software as the VR-ToMIS group, but without any interventions. Effects on psychiatric symptoms, neurocognitive and social cognitive functions, pragmatic language skills and quality of life were evaluated by using analysis of covariance. According to our results, VR-ToMIS was associated with improvements in negative symptoms, in one neurocognitive field (immediate memory), ToM and pragmatic language skills, but no significant change in quality of life scores was detected. Significant changes in VR-ToMIS group were associated with moderate to large therapeutic effects (η_p² = .24–.46, φ = .55–.67). On the background of the presented pilot results, VR-ToMIS is concluded to be feasible and tolerable.