首发精神分裂症重复神经心理测查系统分析

目的用重复神经心理测查系统探讨首发精神分裂症的认知功能损害特点。方法对53例首发精神分裂症患者和62例健康对照用重复神经心理测查系统（RBAN S）和Stroop色词测验进行检测。结果在Stroop色词测验中,病人组的成绩均比对照组差,且差异有统计学意义（P〈0.05）。在RBAN S测查中,病人组5个因子的成绩均比对照组差,且差异有统计学意义（P〈0.05）。结论首发精神分裂症患者可能存在比较严重的全面认知功能损害,范围比较广。     

首发与复发抑郁症患者重复性神经心理测查系统的比较研究

目的探讨首发组和复发组抑郁症患者认知功能损害的特点。方法以166例首发组抑郁症患者和94例复发组抑郁症患者为研究对象。采用汉密尔顿抑郁量表(HAM D-17)评估抑郁严重程度,采用重复性神经心理测查系统(RBAN S)测定认知功能。结果首发组与复发组的抑郁总分(t=-3.476,P<0.05)、迟缓(t=-3.079,P<0.05)和睡眠障碍(t=-3.514,P<0.05)存在显著差异;在RBAN S测查中,首发组与复发组在注意维度(t=2.016,P<0.05)存在显著差异,图形临摹(t=2.278,P<0.05)、线条定位(t=2.133,P<0.05)、图画命名(t=2.031,P<0.05)、编码测验(t=4.123,P<0.05)和图形回忆(t=2.952,P<0.05)分测验结果存在显著差异。结论复发组抑郁症患者认知功能损害较首发组患者严重。     

脑电生物反馈治疗对慢性精神分裂症认知功能影响

目的:探讨脑电生物反馈治疗对慢性精神分裂症患者认知功能的影响。方法:对58例慢性精神分裂症患者在利培酮药物治疗的基础上,分别给予脑电生物反馈治疗(脑电生物反馈治疗组30例)及传统娱疗(传统娱疗组28例)。采用认知评估工具连线测验、简单视觉空间记忆测验(BVMT-R)、WMS-Ⅲ空间广度测验、霍普金斯词语学习测验(HVLT-R)、定步调听觉连续加法测验(PASAT)和威斯康星卡片分类测验(WCST-64)对治疗前及治疗8周后进行神经心理测试。采用阳性和阴性症状量表(PANSS)评定临床症状。结果:治疗前与治疗后PANSS评分两组间无显著差异(P0.05),两组在治疗前神经心理测验成绩无显著差异(P0.05)。治疗8周后,两组间各项神经心理测试比较:空间广度测验的顺行得分、持续错误数、完成分类数无显著差异(P0.05)。连线测验(t=2.10,2.07;P0.05),逆行得分(t=-2.52,P0.05),HVLT-R(t=-2.86,P0.01;t=-3.63,-10.35,P0.001),BVMT-R(t=-5.01,P0.001;t=-3.04,P0.01;t=-4.23,P0.001),PASAT(t=-20.65;P0.001),两组比较均有显著差异。结论:脑电生物反馈治疗对慢性精神分裂症的认知功能改善作用较传统娱疗组明显。     

奎的平和氯丙嗪对精神分裂症认知功能影响的双盲对照研究

目的 :探讨奎的平和氯丙嗪对精神分裂症患者认知功能的影响。方法 :40例精神分裂症患者随机均分为奎的平组和氯丙嗪组 ,在治疗前、治疗后 4、 6周作知识、算术、数字符号、数字广度 (顺、逆 )、木块拼图、瞬时逻辑记忆、视觉再生即刻和延迟、STROOPC测验、词汇流畅、TOH总分 ,计划时间、延迟逻辑记忆、WCST等神经心理测验 ,整个研究过程采用双盲双模拟法。为观察学习效应 ,12例健康者在相同间隔时间作神经心理测验。所得数据用SPSS10 0进行统计分析。结果 :治疗后 ,奎的平组大部分患者神经心理测验成绩提高而氯丙嗪组的测验结果变化不大 ,尤其在注意、执行功能方面。奎的平对精神分裂症患者认知功能的改善作用优于氯丙嗪 (P <0 0 5 )。结论 :奎的平对精神分裂症患者的注意和执行功能有改善作用而氯丙嗪不明显。     

首发精神分裂症患者和精神病高危者的认知功能

目的:探讨首发精神分裂症患者、高危人群及超高危人群的认知功能特点。方法:收集符合美国精神疾病诊断与统计手册第4版(DSM-Ⅳ)的首发精神分裂症患者(41例)、符合精神病风险综合征(SIPS)诊断标准的超高危人群(25例)、精神分裂症患者的非精神病一级亲属(31例)、健康人群(27例),采用连线测验(TMTA)、符号编码、霍普金斯词语学习测验修订版(HVLT)、持续操作测验(CPT)、Stroop色词测验进行认知功能测评。结果:四组人群在连线测验(F=11.45,P0.001)、符号编码(F=11.69,P0.001)、HVLT-R(F=5.34,P0.05)、Stroop单字(F=2.79,P0.05)、Stroop单色(F=3.73,P0.05)、Stroop色词(F=3.83,P0.05)及CPT测验(F=13.62,P0.05)中差异均有统计学意义。患者一级亲属和超高危人群认知功能介于首发精神分裂症患者和健康人群之间,且患者一级亲属要好于超高危人群(Ps0.05)。结论:精神分裂症的患者一级亲属、超高危个体以及首发精神分裂症患者的认知功能损害依次加重,提示认知损害的程度与患病风险相关。     

首发精神分裂症患者近期和远期复发的相关因素

目的探讨引起首发精神分裂症患者近期和远期复发的相关因素。方法对164例首发精神分裂症患者进行长期随访,于治疗一年末、四年末各做一次韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击试验、动作功能测验、手功能协调测验、连线测验A和B、威斯康星卡片分类测验(WCST)及言语流利性测验10项神经心理测查及治疗一年内每月一次BPRS、SDSS评定,治疗一年至四年内每三月一次BPRS、SDSS评定。我们分别根据患者治疗一年内和一年至四年的BPRS结果将患者分为复发组和未复发组,即一年内或一年至四年只要有一次复发就分到复发组,分别比较治疗一年末和四年末复发组和未复发组各项认知功能及年龄、受教育年限、DUP(未治疗的精神病期)等特征有无显著性差异。结果治疗一年末复发组的DUP显著长于未复发组(24.4±18.4/16.5±17.4,t=-2.19,P<0.05),其余各项指标差异均无统计学显著性;治疗四年末复发组和未复发组各项指标差异均无统计学显著性。结论首发精神分裂症患者的DUP长短与患者的近期预后有关,DUP越短,近期预后越好;DUP为近期内复发的相关因素。     

精神分裂症患者一级亲属的事件相关电位及与神经认知功能的相关性

目的:探索精神分裂症患者无症状一级亲属的早期认知功能改变的内源性标记物，及与认知功能特定的维度受损相关性。方法:选取符合美国精神障碍诊断与统计手册第5版(DSM-5)精神分裂症诊断标准的患者22例，其无症状一级亲属24例，正常对照27例。采用听觉oddball范式进行事件相关电位N200、P300测试，采用精神分裂症认知功能成套测验(MCCB)进行神经认知功能测评。结果:精神分裂症组的N200、P300潜伏期较一级亲属组和正常对照组均延长，P300振幅降低；一级亲属组的P300潜伏期较正常对照组延长(均P<0.05)。精神分裂症患者组在6项神经认知功能测验中的评分明显低于一级亲属组和正常对照组(均P<0.05);而一级亲属组各项认知功能评分与正常对照组差异均无统计学意义(P>0.05)。精神分裂症组和一级亲属组的N200潜伏期与符号编码评分均呈负相关(r=-0.15、-0.49,均P<0.05),P300潜伏期与词语学习均呈负相关(r=-0.12、-0.49,均P<0.05)。结论：ERPs可为精神分裂症无症状一级亲属的早期认知功能改变的识别提供客观依据。     

首发精神分裂症关系妄想症状的神经认知病理改变

目的:对关系妄想(DOR)可能的神经认知机制进行研究。方法:入组首发精神分裂症患者43例,其中关系妄想组(DOR组)15例,非关系妄想组(Non-DOR)28例;另入组健康对照(HC)47例。采用轮廓整合测验、Babble测验测试所有受试者的听觉、视觉信号的组织能力。结果:DOR组在Babble测验中其正确词数与错词数目与Non-DOR组和HC无明显差异(P0.05),而错词长度显著高于HC和Non-DOR组(P0.05);DOR患者的轮廓整合能力较HC整体上未发现明显下降(P0.05),但在随机测验25°水平的错误得分上,显著高于HC(P0.05)且与牵连观念访谈量表得分呈显著正相关(r=0.239,P=0.023)。结论:以DOR为主要临床表现的首发精神分裂症患者对听觉和视觉水平的无关信息的过度提取可能是DOR的神经认知的病理基础。     

双相情感障碍患者及其健康同胞威斯康星卡片分类测验的比较研究

目的:探讨双相情感障碍患者及其健康同胞的执行功能特点.方法:采用威斯康星卡片分类测验(WCST)对29例双相情感障碍患者(患者组)及其健康同胞29名(同胞组),以及51名正常对照者(正常对照组)进行执行功能评估.结果:①与正常对照组相比,患者组在WCST的完成测验总应答数、持续错误数、随机错误数均显著高于正常对照组(P<0.05).②与正常对照组相比,同胞组持续错误数显著高于正常对照组(P<0.05).③与同胞组相比,患者组的随机错误数显著增高(P<0.05).结论:双相情感障碍患者及其健康同胞可能均存在执行功能缺陷.     

精神分裂症关系妄想患者的神经认知改变

目的:探讨精神分裂症关系妄想患者的临床特征、神经认知与心理防御特点。方法:2017年1月至2018年12月某院精神科门诊或病房收治的100例首发精神分裂症患者。根据阳性症状量表(SAPS)得分情况将100例受试者分为关系妄想组(46例)和非关系妄想组(54例)。选择同期来本院进行体检的健康人50例,设为健康对照组。对所有受试者进行牵连观念访谈表(IRIS)评估。对首发精神分裂症患者进行阳性症状量表(SAPS)、阴性症状量表(SANS)评估。使用Babble测验评价受试者的听觉提取情况。使用轮廓整合测验评价受试者的视觉提取情况。应用防御方式问卷(DSQ)评价受试者的心理防御状况。应用自测健康评定量表(SRHMSV 1.0)评价受试者生理健康、心理健康和社会健康。结果:Babble检测结果显示,关系妄想组的错误词数明显多于非关系妄想组和健康对照组(F=6.509,P0.01),错词长度均明显长于非关系妄想组和健康对照组,差异均有统计学意义(F=33.838,P0.01)。轮廓整合测验结果显示,关系妄想组随机测验正确总分、标准测验的正确总分均明显低于非关系妄想组和健康对照组,错误总分均明显高于非关系妄想组和健康对照组,差异有统计学意义(F=9.447,7.449,10.367,12.445;P0.05)。防御方式问卷(DSQ)检测结果显示,关系妄想组投射、潜意显现、抱怨、压抑、理想化、伴无能之全能、隔离、同一化、否认、交往倾向、因子3、掩饰因子的得分均与非关系妄想组、健康对照组存在明显统计学差异(F=6.321～18.478,P0.05)。关系妄想组的生理健康、心理健康和社会健康评分及SRHMSV 1.0量表总分均明显低于非关系妄想组和健康对照组,差异均有统计学意义(F=14.276,12.122,14.306,20.033;P0.05)。结论:对听觉、视觉水平的无关信息的过度提取,以及较多的应用不成熟的心理防御机制,可能是精神分裂症关系妄想患者的病理基础。     

Antisaccade deficit is present in young first-episode patients with schizophrenia but not in their healthy young siblings

BACKGROUND: Results of studies on antisaccade (AS) deficit in relatives of patients with schizophrenia are inconclusive. We hypothesized that AS performance in siblings of patients with schizophrenia is worse than in healthy controls and better than in patients with schizophrenia. METHOD: We included 55 first-episode patients with schizophrenia, 28 healthy siblings and 36 healthy controls to evaluate AS performance. Eye movements were measured electromagnetically by the double magnetic induction (DMI) method. RESULTS: Patients with schizophrenia had a significantly higher error rate than siblings (d=0.86, p<0.0001) and controls (d=1.35, p<0.0001). Siblings had a higher mean error rate than healthy controls but this did not reach significance (d=0.56, p=0.29). The intra-class correlation (ICC) was 0.33 for the error rate. Mean AS gain was higher in siblings than in patients (d=0.75, p=0.004) and controls (d=0.6, p=0.05). The ICC was 0.08. CONCLUSION: As parameters in strictly screened healthy young siblings of young first-episode patients with schizophrenia are comparable to results found in studies investigating older relatives. However, the statistical results (i.e. the ICCs) suggest that there is little evidence of shared environmental or genetic factors on error rate variation.     

Further antinociceptive effects of myricitrin in chemical models of overt nociception in mice

Neurocognitive de?cits are recognized as core features of schizophrenia. The aim of this study was to compare the cognitive performance of antipsychotic, drug-naive patients with first-episode schizophrenia (FES patients) to their healthy siblings and to healthy controls from the Han Chinese population for exploring potential endophenotypes for the early detection of schizophrenia. A battery of cognitive assessment tools was used to measure seven cognitive domains in matched groups consisting of 56 subjects each. Cognitive tests included the grooved pegboard test (GPT), the category fluency test (CFT), the trail making test A (TMT-A), the Wechsler memory scale-III spatial span test (WMS-III SST), the Hopkins verbal learning test-revised (HVLT-R), the brief visuospatial memory test-revised (BVMT-R), the paced auditory serial addition test (PASAT), and the Wisconsin card sorting test-64 cards version (WCST-64). The performances of FEP patients were inferior to normal controls on all neuropsychological tests, while siblings were lower than healthy controls in many of the same tasks. Patients’ performances were lower than siblings’ on all tests except for the CFT, the WMS-III SST backward test, and four subtests of the WCST-64. Our data suggest that FEP patients exhibited pronounced impairment of fine motor skills, speed of processing, attention, verbal memory, visual memory, and executive function, while siblings exhibited deficits intermediate between those of schizophrenic patients and the control group. Semantic fluency function and executive function may be potential endophenotypes for the early diagnosis of schizophrenia.     

Reduced prefrontal activation during Tower of London in first-episode schizophrenia: A multi-channel near-infrared spectroscopy study

Cognitive impairments are considered as a core feature of schizophrenia and have been reported in associated with dysfunction of the prefrontal cortex (PFC). The Tower of London (TOL) task is a widely used neuropsychological test to assess the planning ability and the PFC function. In the present study, we examined functional changes in the PFC of 40 first-episode schizophrenia patients and 40 age- and gender-matched healthy controls by means of multi-channel Near-infrared spectroscopy (NIRS) during performance of the TOL task. NIRS is a noninvasive optical method that can measure relative changes in oxygenated ([oxy-Hb]) and deoxygenated ([deoxy-Hb]) hemoglobin in cortical tissue. Compared to the healthy controls, schizophrenia patients exhibited a significant decreased activation in the left PFC and poorer TOL performance. The results confirm the functional deficits of the PFC and impaired planning ability in first-episode schizophrenia patients and suggest that NIRS may be a useful clinical tool for evaluating PFC activation in psychiatric disorders.     

Neuropsychological correlates of N400 anomalies in patients with schizophrenia: A preliminary report

We investigated N400 anomalies and their relationship with neuropsychological disturbance of schizophrenia. Twelve patients with schizophrenia and 12 normal controls, matched for age, sex, education and handedness underwent both the neuropsychological test and the electrophysiological recordings employing semantic violation sentence paradigm. The patients with schizophrenia showed a reduced N400 amplitude and worse performance in the frontal lobe function test compared to healthy participants. Furthermore, statistically significant positive correlations were found between N400 amplitude and neuropsychological performances on the Stroop Task and Wisconsin Card Sorting Test in patients with schizophrenia. Our results suggest the possibility that N400 anomalies reflect the disturbed integrity of the fronto-temporal network in schizophrenia evidenced by neuropsychological deficits. In addition, we concluded that the N400 amplitude is a candidate for an endophenotype marker of schizophrenia by revealing its relationship to neuropsychological deficits.     

Visual-perceptual dysfunctions are possible endophenotypes of schizophrenia: evidence from the psychophysical investigation of magnocellular and parvocellular pathways

Visual information processing is impaired in schizophrenia patients and their biological relatives. The authors measured vernier thresholds in 72 schizophrenia patients, their 86 siblings, and 60 healthy control subjects. Subjects were asked to detect the direction of the horizontal displacement of 2 stimuli (left or right). During magnocellular (M) pathway tests, stimuli were dots with low contrast (5%) or counterphase-modulated gratings (25 Hz). For parvocellular (P) pathway tests, isoluminant blue-red dots with yellow-green background were used. Results revealed that patients with schizophrenia and their siblings were more impaired in M pathway conditions than in P pathway conditions. There was no color-specific impairment. The patients and their siblings displayed lower performances on tests of executive functions, psychomotor speed, and verbal memory compared with the controls. Visual-perceptual and neuropsychological data did not correlate. In conclusion, M pathway dysfunction is a potential endophenotype of schizophrenia.     

精神分裂症患者及其健康同胞脑白质密度研究

目的:观察精神分裂症患者及其健康同胞脑白质密度的特点.方法:用基于像素的形态学测量法比较三组的白质密度.结果:在左侧前额叶和胼胝体膝部,患者及同胞的白质密度值显著小于正常对照组,患者和同胞之间的差异未达到统计学意义水平.结论:左侧前额叶和胼胝体膝部白质密度值降低可能与精神分裂症的患病风险有关.     

Reduced visual P300 amplitudes in individuals at ultra-high risk for psychosis and first-episode schizophrenia

The purpose of this study was to investigate whether individuals at ultra-high risk (UHR) for psychosis and patients experiencing first-episode schizophrenia had impairments in visual information processing as indexed by the visual P300 event-related potential. Sixteen UHR individuals, 21 first-episode schizophrenia patients, and 16 healthy controls were included. Participants were asked to perform a visuospatial oddball task while undergoing an electroencephalogram. The UHR and first-episode groups showed reduced P300 amplitudes in comparison to healthy controls. P300 amplitudes were negatively correlated with severity of negative symptoms in both the UHR and first-episode groups. These results suggest that the visual P300 may be a neurobiological vulnerability marker, reflecting neurophysiological abnormalities associated with enduring negative symptoms in schizophrenia.     

Feature uncertainty: a novel test to probe prefrontal dysfunction in unaffected siblings of schizophrenia patients

Previous studies indicated that neuropsychological impairments are potential endophenotypes of schizophrenia. However, the sensitivity of these procedures is not sufficient and their brain substrates are poorly defined. The aim of this study was to measure the behavioral performance of siblings of schizophrenia patients and controls on a novel feature uncertainty (FU) task that selectively activates dorsal anterior cingulate cortex relative to orientation (OR) and spatial frequency (SF) discrimination. During the FU task, two subsequent sinusoidal gratings are presented and participants are asked to remember both the OR and SF of the gratings. After the disappearance of the gratings, a color cue signifies the perceptual dimension (OR or SF) to discriminate. Results revealed that the siblings of schizophrenia patients (n = 25) showed a selective deficit on the FU task as compared with controls (n = 20). The FU deficit was more severe than that found on neuropsychological tests of executive functions, psychomotor speed, and verbal memory. These results suggest that anterior cingulate dysfunction is a potential endophenotype of schizophrenia.     

Memory-guided saccade abnormalities in schizophrenic patients and their healthy, full biological siblings

BACKGROUND: Ocular-motor inhibition errors and saccadic hypometria occur at elevated rates in biological relatives of schizophrenic patients. The memory-guided saccade (MS) paradigm requires a subject to inhibit reflexive saccades (RSs) and to programme a delayed saccade towards a remembered target. METHOD: MS, RS, and central fixation (CF) tasks were administered to 16 patients who met the criteria for DSM-IV schizophrenia, 19 of their psychiatrically healthy siblings, and 18 controls. RESULTS: Patients and siblings showed elevated MS error rates reflecting a failure to inhibit RSs to a visible target, as required by the task. In contrast to controls, prior errors did not improve MS accuracy in patients and siblings. CONCLUSIONS: The specific characteristics of the elevated MS error rate help to clarify the nature of the disinhibition impairment found in schizophrenics and their healthy siblings. Failure to inhibit premature saccades and to improve the accuracy of subsequent volitional saccades implicates a deficit in spatial working-memory integration, mental representation and/or motor learning processes in schizophrenia.     

精神分裂症患者的认知功能改变的研究

目的：探讨精神分裂症的认知功能损害特点。方法：对21例分裂样精神障碍，26例精神分裂症和22名健康对照组进行威期康星卡片分类测验，词汇流畅测验，联想学习，领悟，相似和数字广度测验，结果：在所有的神经心理测验中，分裂症样精神障碍组和精神分裂症组成绩均显著低于对照组（均P＜0．05），威期 星卡分分类测验与其它各项神经心理测验无明显的相关。结论：精神分裂症患者存在认知功能损害。