精神分裂症患者脑部CT临床对照研究

为探讨精神分裂症患者脑ＣＴ结果与临床的相关性，对１９９５年１月～１９９６年５月住院符合ＣＣＭＤ—２—Ｒ诊断标准的精神分裂症患者进行脑部ＣＴ检查，以同期门诊神经症患者的脑ＣＴ检查报告作对照，并与临床相关因素进行对照分析。结果发现精神分裂症组脑ＣＴ异常６９例（３２．４％），与对照组比较有极显著差异；前者病程＞５年，年龄４０岁以上，以阴性症状为主患者的脑萎缩发生率最高。     

精神分裂症的脑CT对照研究

目的 为了论证精神分裂症与脑结构异常的关系。将符合ＣＣＭＤ－Ⅱ－Ｒ的４２例男怀精神分裂症患者与２３例健康者进行脑ＣＴ对照研究。方法 采用ＣＴ扫描机对入组对象进行头颅扫描，并对患者的年龄、病程和疗效与脑ＣＴ作相关分析。结果 患者组的侧体部最大外径、脑沟宽度及侧裂池宽度与对照组有显著差异。年龄和病程与脑结构异常相关性，在排除年龄因素的影响之后仍提示病程与脑结构异常有密切关系。结论在部分精神分裂患者中，     

精照研神分裂症的脑CT对究

目的 为了论证精神分裂症与脑结构异常的关系,将符合CCMD—Ⅱ—R的42例男性精神分裂症患者与23例健康者进行脑CT对照研究。方法 采用CT扫描机对入组对象进行头颅扫描,并对患者的年龄、病程和疗效与脑CT作相关分析。结果 患者组的侧脑室体部间最大外径、脑沟宽度及侧裂池宽度与对照组有显著差异(P<0.05)。年龄和病程与脑结构异常呈相关性,在排除年龄因素的影响之后仍提示病程与脑结构异常有密切关系。结论 在部分精神分裂症患者中,确实存在脑结构异常,其病因有待进一步研究。     

精神分裂症患者脑CT与临床的10年随访研究

目的探讨精神分裂症的脑萎缩与临床表现的相关性。方法对３２例精神分裂症患者的脑ＣＴ与临床进行了１０年的随访研究，采用简明精神病评定量表、阴性症状量表、阳性症状量表、社会功能缺陷筛选量表、简易智力状态检查对其临床症状、社会功能和智能状况进行评定。结果１０年前３２例患者中有５例（１６％）脑萎缩，１０年后为１０例（３１％）脑萎缩；８例脑室大小正常，但双侧脑室不对称；１４例正常。随访时量表评定结果提示，该组患者以阴性症状为主，社会功能下降，认识功能有不同程度的损害，脑萎缩患者与非脑萎缩患者比较，差异未见显著性，但病程明显长于非脑萎缩患者。精神分裂症患者的脑萎缩与精神病家族史、亚型和各项治疗无明显关系。结论精神分裂症患者的脑结构异常与病程呈正相关。     

微小躯体异常与慢性精神分裂症的关系

目的：探讨微小躯体异常（ＭＰＡ）与慢性精神分裂症临床及脑部结构异常之间的相互关系。方法：对３９例具微小躯体异常的慢性精神分裂症患者进行脑ＣＴ检查，以无ＭＰＡ的３９例为对照组进行比较。采用ＳＡＰＳ与ＳＡＮＳ评定精神症状。结果：３９例微小躯体异常的精神分裂症患者脑室系统均较对照组显著扩大，而阴性精神症状分亦较对照组增高，微小躯体异常慢性精神分裂症与脑室扩大及阴性症状严重性有关。结论：微小躯体异常的慢性精神分裂症患者病情严重，病程长，可能表示有早年精神发育障碍，成为精神分裂症易感素质的基础     

酒依赖的脑CT对照研究

目的：论证酒依赖与结构异常的关系。方法将符合ＣＣＭＤ－Ⅱ－Ｒ的３１例男性酒依赖患者与２３例健康者进行脑ＣＴ对照研究,并对患者的酒龄,酒量和饮酒开始年龄等与脑ＣＴ值相关分析。结果患者的脑沟宽度、第三脑室宽度及侧裂池宽度与对照组有显著差异（Ｐ〈０．０５）。饮酒时间与脑结构异常相关。结论男性酒依赖患者存在脑结构异常。     

以阴性症状为主的精神分裂症患者认知功能与局部脑血流的 …

目的 动态观察药物对局部脑血流量（ｒＣＢＦ）的影响,探索以阴性症状为主的精神分裂症患者潜隐的局部脑功能异常。方法 对２１例符合Ａｎｄｒｅａｓｏｎ阴性精神分裂症标准的患者（以下简称患者组）于氯氮平治疗前后进行威斯康星卡片分类测验（ＷＣＳＴ）和单光子发射计算机断层扫描（ＳＰＥＣＴ）检查,以４０名正常人为对照组（其中２８名为ＷＣＳＴ对照组,１２名为ＳＰＥＣＴ对照组）。结果 患者组氯氮平治疗前后ＷＣＳＴ的     

精神分裂症的阴性症状与额叶功能障碍

目的：探讨精神分裂症阴性症状与额叶功能的关系。方法：应用９９ｍＴＣ－乙撑双半胱氨酸二乙酯ＳＰＥＣＴ技术，以范畴测验为心理作业任务，测量９例高阴性症状与１３例低阴性症状的精神分裂症患者静息状态与心理作业时的局部脑血流（ｒＣＢＦ），并与１０例正常对照组比较。结果：静息状态时，阴性症状与左下额叶ｒＣＢＦ呈显著负相关，低阴性组左下额叶血流灌注增高。心理作业时，阴性症状与右上额叶ｒＣＢＦ呈显著负相关，高阴性组右上额叶血流灌注低于低阴性组。两病例组左、右额叶ｒＣＢＦ均低于正常对照组。结论：精神分裂症阴性症状可能与左下额叶及右上额叶功能障碍有关     

87例抑郁症患者的脑CT和临床分析

本文对８７例抑郁症患者和４５例常人的脑ＣＴ作了对照研究，结果发现抑郁症患者ＣＴ异常１８例，对照组仅１例异常，两组对比差异显著，抑郁症患者有精神病性症状者脑ＣＴ异常率明显高于无精神病性症状者，脑ＣＴ异常与病程、年龄、性别、精神疾病家族史及接受治疗与否无关。提示伴精神性症状的抑郁症比其他亚型更可能有发病的生物学基础，额叶损害可能与抑郁症的发生有关。     

精神分裂症患者视觉P_(300)研究

目的探讨精神分裂症患者Ｐ３００异常与临床症状的关系。方法３９例精神分裂症患者，依据Ａｎｄｒｅａｓｏｎ分型分为阳性症状、阴性症状及混合型三组，分别记录Ｆｚ，Ｃｚ，Ｐｚ，Ｏｚ，Ｃ３及Ｃ４的视觉Ｐ３００。结果精神分裂症组的Ｐ３００潜伏期延长、幅度减低与对照组比较有显著差异；阳性症状组的Ｐ３００幅度左侧中央区显著低于右侧，混合型与阴性症状组以额区Ｐ３００幅度减低为显著特征。结论精神分裂症阳性症状与阴性症状组间有不同脑区Ｐ３００改变模式，提示两组间可能存在不同的神经生理损害     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

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.     

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.