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。     

精神分裂症患者不同状态探究性眼球轨迹运动研究

目的 :比较精神分裂症患者不同状态下探究性眼球轨迹运动的差异及判别分析结果。方法 :应用眼球轨迹运动记录仪测试正常人组 2 2例 ;精神分裂症患者症状显著组 2 6例 ,缓解组 61例 ,慢性组 (阴性症状为主 ) 3 0例 ,并进行组间比较。结果 :正常人对照组为负分 ( -1 2 75 ) ,精神分裂症患者各组均为正分 ;其中症状显著组 1 85 8分 ,症状缓解组 2 3 3 2分 ,慢性组 3 499分。正常对照组与精神分裂症患者各组在眼球轨迹运动各项指标比较其差异均有显著性 (P <0 0 5～ 0 0 1)。显著组和缓解组与慢性组某些指标比较其差异同样有显著性 (P <0 0 5～ 0 0 1) ,但显著组与缓解组所有指标比较其差异均无显著性 (P >0 0 5 )。结论 :探究性眼球轨迹运动对精神分裂症患者诊断可起到一定的辅助作用。反应性探究分 (RSS)可作为精神分裂症特定的生物学指标之一。     

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。     

不同病程的精神分裂症患者探究性眼动分析

目的 :探讨探究性眼球轨迹运动 (EETM )对精神分裂症不同病程的影响及其组间比较。方法 :应用眼球轨迹运动标记记录仪 (MODELIV ,日本提供 )对 13 3例病程小于 1年 (第 1组 ) ,14 8例病程在1～ 5年 (第 2组 ) ,10 5例病程在 5～ 10年 (第 3组 ) ,112例病程在 10年以上 (第 4组 )四组不同病程的精神分裂症患者和 81人的正常对照组进行实验检查。用差别分析值 (DiscriminantAnalysis ,D分值 ) ,眼固定点数 (NumberofEyeFixations ,NEF) ,反应性探索分 (ResponsiveSearchScore ,RSS) ,认知性探索分 (CognitiveSearchScore ,CSS) ,眼示踪总距离 (TotalEyeScanning ,TESL) ,眼示踪平均距离 (MeanEyeScanning ,MESL)分析四组实验结果并进行各组间比较。结果 :498例精神分裂症患者获正分 3 86人 (敏感性 77 5 % ) ,负分112人 ;81人正常对照组获正分 7人 ,负分 74人 (特异性 91 4% )。D分值、EETM在正常人受试者与精神分裂症组间比较其差异有非常显著性 (P <0 0 1) ;D分值、EETM在第 1组与第 4组间比较除NEF、MESL外 ,其它指标差异有显著性 (P <0 0 5 ) ;EETM其它各组间比较其差异无显著性 (P >0 0 5 )。结论 :眼球轨迹运动实验检查是对精神分裂症敏感性较强的辅助诊断工具 ;病程较长的精神分裂症其认知功能     

急性而短暂的精神病性障碍患者的探究性眼球轨迹运动

目的:研究急性而短暂的精神病性障碍(ATPD)患者探究性眼球轨迹运动及其对疾病转归的临床意义。方法:对符合国际疾病和相关健康问题统计分类第十版(ICD-10)诊断标准的来自病房或门诊的34例ATPD患者、33例精神分裂症患者及29例正常对照进行探究性眼球轨迹运动检查并分析眼动参数。三组受试年龄、性别和受教育程度均匹配。用阳性和阴性症状量表(PANSS)评定患者的精神症状。ATPD患者在入组时及入组1个月后各行1次眼动检查,另外两组均行1次眼动检查。对ATPD患者进行随访以了解诊断变化。结果:ATPD患者眼动参数反应性探究分、认知性探究分均低于正常对照(P<0.05),判别分析(discriminant analysis,D分)值高于正常对照。经至少1个月随访,18例ATPD患者改诊为精神分裂症,其中首次D分值为正分占72.22%;这18例患者首次D分值高于正常对照和16例改诊为其他精神障碍者(P<0.05),而与精神分裂症患者差异无统计学意义。结论:急性而短暂的精神病性障碍患者探究性眼球轨迹运动存在异常;判别分析值正分可能为急性而短暂的精神病性障碍转归为精神分裂症提供一种有价值的预测指标。     

强迫症患者眼球运动异常研究

目的：研究强迫症患者探究性眼球运动及其与临床的关系。方法：对符合DSM—Ⅳ诊断标准的57例强迫症（其中27例无用药史，30例有用药史）和50例在性别、年龄和受教育水平方面与之相匹配的正常人进行探究性眼球运动检查，并分析探究性眼球运动与临床的关系。结果：强迫症患者的探究性眼球运动多数指标均低于正常人（P〈0．05或者P〈0．01）；强迫症患者差别分析值正分者占37％，而正常对照组为8％，两者差异具有统计学显著性（x^2=12．27，P〈0．001）、以眼球运动指标为因变量并以临床变量为自变量进行多元逐步回归分析，在α=0．05水平，被选人反应性探究分回归方程者有思维形式障碍（如赘述）；选人认知性探究分回归方程者为强迫症状诱发因素、病程、精神运动迟缓分、Mausley强迫症状总分。结论：强迫症患者探究性眼球运动异常，支持强迫症额叶皮层-基底节异常学说，强迫症与精神分裂症存生物学上存在某些关联或者重叠。     

探究性眼球轨迹运动对50例精神分裂症患者及家系的分析研究

目的：探讨探究性眼球轨迹运动对精神分裂症患者的诊断及其与他们的父母,同胞等遗传关系的研究。方法：使用眼球轨迹运动检查仪对50例精神分裂症患者及其他们的父母双亲,同胞各50－人进行测试,并测试正常健康对照组30人,以差别分析值（Discriminant analysis,D分）的结果来判定其是否为精神分裂症性障碍,凡D分是正分为精神分裂症性障碍,负分为非精神分裂症性障碍,用阳性和阴性量表（PANSS）评定精神症状,按ICD－10和DSM－IV诊断标准检查每一受试者。结果：50例精神分裂症患者有40人D分值为正分（40／50人,80．0％）,患者的父亲50人中有2人确诊为精神分裂症,23人D分值为正分（23／48人,47．9％）,同胞50人中有5人确诊为精神分裂症,25人D吩值为正分（23／45人,51．1％）,正常健康对照组30人中有4人D分值为正分（4／30人,13．3％）,患者与父亲,母亲,同胞之间在反应性探究分（RSS）,眼运动注视点数（NEF）,认知性探究分（CSS）,眼视[踪总距离（TESL）,眼视踪平均距离（MESL）等比较均有非常显著性差异（P＜0．01）;在父亲与母亲,父亲与同胞,母亲与同胞之间比较除个别项目外,均无显著性差异（P＞0．05）,结论：眼球轨迹运动作为对精神分裂症的辅助诊断具有特异性,可能是生物遗传学素质指标。     

31例抑郁症患者探究性眼球轨迹运动分析

目的探讨抑郁症患者探究性眼球轨迹标记运动的临床特征。方法应用探究性眼球轨迹运动标记记录仪(Type-Ⅳ)和汉密尔顿抑郁量表(HamiltonDepressionScale,HAMD)对31例抑郁症患者于治疗前后分别进行两次检查,间隔时间(34±8)天;31例正常人对照组只作一次检查。结果判别分析值(Discriminantanalysis,D分值)在抑郁症组前后两次检查的结果(0.52±1.58,0.79±1.44)均高于正常人对照组(-1.00±0.85),差异均有统计学显著性(t=4.40、5.80,P<0.01)。抑郁症组前后两次检查HAMD量表评分差异有显著性(32.14±5.72,17.48±7.82,t=11.91,P<0.01),但前后两次探究性眼球轨迹运动主要指标之间比较其差别无显著性(P>0.05)。结论抑郁症组与正常对照组探究性眼球轨迹运动结果不同,抑郁症组经过抗抑郁剂治疗后,探究性眼球轨迹运动主要指标前后两次比较无明显变化。     

联合客观检查判别精神分裂症病人初探

目的:初步探讨综合运用多项客观检查判别精神分裂症的可能性.方法:病人组40例,符合DSM-Ⅳ精神分裂症诊断标准,且目前未接受抗精神病治疗;健康正常人41例,性别、年龄、利手和教育程度与病人匹配.顺序完成脑电图相干性分析、探究性眼球轨迹运动(眼动)、连续操作测试(CPT)和威斯康星卡片分类测试(WCST)检查,然后进行逐步判别分析.结果:单项以眼动检查的正确判别率最高,对精神分裂症为67.6%,正常人89.7%,合计77.27%.综合运用多项检查指标的正确判别率,对病人为77.8%,正常对照86.2%,合计81.5%.结论:由于精神分裂症具有明显的异质性,综合多项检查的指标,有可能提高对精神分裂症的判别.     

阴、阳性症状为主的精神分裂症患者神经认知功能的比较研究

目的：探讨阳性症状为主型（阳性型）及阴性症状为主型（阴性型）精神分裂症患者的神经认知功能状况。方法：采用木块图、线方向判断、视觉再生、理解记忆、连线及威斯康星卡片分类（WCST）测验，对25例阴性型精神分裂症患者和20例阳性型精神分裂症患者进行评定。结果：阴性组患者的视觉再生、理解记忆、木块图，连线B时间、思维灵活性以及WCST持续性错误百分数、完成分类数等成绩显著低于阳性组；其中木块图、连线B时间、思维灵活性以及WCST持续性错误百分数指标与SANS总分均有显著相关；视觉再生、理解记忆测验得分及WCST完成分类数与SANS及SAPS总分均有显著相关。结论：不同亚型精神分裂症患者神经认知功能损害的特点不同。顶叶及额叶功能下降与阴性症状关系密切；而颞叶功能下降与阴性、阳性症状均密切相关。     

Specific Neuropsychological Deficits in Schizophrenic Patients with Preserved Intellectual Function

Although a wide range of cognitive deficits have been demonstrated in schizophrenia, it is not clear whether specific deficits stand out from general intellectual decline. Separate cases have been made for selective impairments in mnemonic and in executive function but these remain unconfirmed. A common problem in studies of schizophrenia is heterogeneity of deficits and Shallice, Burgess, and Frith (1991) have addressed this by using a single case study approach. The present study used the CANTAB battery of neuropsychological tests to examine cognitive performance in a small group of schizophrenic patients with preserved intellectual function. This test battery allows a componential analysis of performance, and its neurological validation may enable specific neurobiological hypotheses to be addressed. Twelve schizophrenic patients with current IQ greater than 90 and within 10 points of premorbid IQ were assessed on tests of visuospatial memory, spatial working memory, planning, and attentional set-shifting. Their performance was compared to that of 12 matched controls. The patient group, as a whole, was impaired on all tasks but the pattern of impairment varied across individuals. Consistently, severe deficits were seen on tests of delayed matching to sample and attentional set-shifting. These deficits are compared to those seen in patients with unipolar depression, who showed similar deficits in delayed matching to sample but not set-shifting, and are considered in terms of common cognitive mechanisms and possible neural substrates.     

Neurocognitive deficits in first-episode schizophrenic patients and their first-degree relatives.

Some neuropsychological abilities, particularly those affecting memory, attention and executive function, are impaired amongst both schizophrenic patients and their unaffected relatives, implying that these deficits are at least partly genetic in origin. However neuropsychological performance can be altered by medication, and has rarely been examined in first onset, drug naive patients. The objective of this study was to determine whether selected neurocognitive abilities are impaired in first-onset schizophrenic patients and their relatives compared to controls. We examined attention and speed of information processing, memory and learning, verbal function, visuoconstructive abilities and executive function in 207 first-episode schizophrenic patients (163 of whom were drug na?ve), 322 of their first-degree relatives and 133 unrelated normal controls. The data were subjected to multilevel modeling to compare neurocognitive performance between schizophrenic probands, relatives and controls while taking into account potential correlations among members of the same family; age, gender, and years of education were included as covariates. Of the three groups, schizophrenic patients performed poorest at all neuropsychological tests, suggestive of a broad range of neurocognitive deficits. Their first-degree relatives showed a narrower pattern of poor performance at Digit Symbol, Digit Span, Trail Making, Verbal Fluency test, Tower of Hanoi, and WCST-M tests. Our findings show that selected neurocognitive deficits especially attention and executive function are impaired in the families of schizophrenic patients. These patterns of neurocognitive deficits may represent "endophenotypes" denoting varying degrees of vulnerability to schizophrenia and may be of value in future molecular genetic studies.     

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.     

Probing the mechanism of saccade-associated head movements through observations of head movement propensity and cognition in the elderly

Humans may accomplish gaze shifts by eye-only saccades or combined eye–head saccades. The mechanisms that determine whether the head moves remain poorly understood. Many observations can be explained if phylogenetically ancient circuits generate eye–head saccades by default and frontal cerebral structures interrupt this synergy when eye-only saccades are preferable. Saccade-associated head movements have been reported to increase in the elderly. To test the hypothesis of frontal inhibition of head movements, we investigated whether the increase is associated with a decline in frontal cognitive function. We measured head movement tendencies and cognition in volunteers aged 61–80. Measures of head movement tendency included the customary range of eye eccentricity, customary range of head eccentricity, range of target eccentricities evoking predominantly eye-only saccades, and two measures of head amplitude variation as a function of target eccentricity. Cognitive measures encompassed verbal fluency, verbal memory, non-verbal memory, and executive function. There was no correlation between cognition and any measure of head movement tendency. We combined these elderly data with measurements of head movements in a group aged 21–67 and found mildly reduced, not increased, head movement tendencies with age. However, when confronted with a task that could be accomplished without moving the head, young subjects were more likely to cease all head movements. While inconclusive regarding the hypothesis of inhibition of saccade-associated head movements by cerebral structures, the results indicate the need to distinguish between mechanisms that define head movement tendencies and mechanisms that adapt head motion to the geometry of a specific task.     

Deficits in predictive smooth pursuit after mild traumatic brain injury

Given that even mild traumatic brain injury (TBI) may produce extensive diffuse axonal injury (DAI), we hypothesized that mild TBI patients would show deficits in predictive smooth pursuit eye movements (SPEM), associated with impaired cognitive functions, as these processes are dependent on common white matter connectivity between multiple cerebral and cerebellar regions. The ability to predict target trajectories during SPEM was investigated in 21 mild TBI patients using a periodic sinusoidal paradigm. Compared to 26 control subjects, TBI patients demonstrated decreased target prediction. TBI patients also showed increased eye position error and variability of eye position, which correlated with decreased target prediction. In all subjects, average target prediction, eye position error and eye position variability correlated with scores related to attention and executive function on the California Verbal Learning Test (CVLT-II). However, there were no differences between TBI and control groups in average eye gain or intra-individual eye gain variability, or in performance on the Wechsler Abbreviated Scale of Intelligence (WASI), suggesting that the observed deficits did not result from general oculomotor impairment or reduced IQ. The correlation between SPEM performance and CVLT-II scores suggests that predictive SPEM may be a sensitive assay of cognitive functioning, including attention and executive function. This is the first report to our knowledge that TBI patients show impaired predictive SPEM and eye position variability, and that these impairments correlate with cognitive deficits.     

Socioaffective factors modulate working memory in schizophrenia patients

Working memory deficit in schizophrenia is a core cognitive feature of the disorder and is reliably associated with abnormalities of the prefrontal circuitry. Working memory deficits are also associated with impaired social functioning and present a major obstacle toward successful rehabilitation in schizophrenia. Although the role of prefrontal cortex in working memory has been extensively investigated, the intricate relations among the prefrontal circuitry, working memory and social behaviors are not clearly understood. In this study, we manipulated social context and observed its effects on spatial working memory. In experiment 1, the effects of social and asocial reinforcements on spatial working memory were examined in schizophrenic patients and healthy controls. The results show that social but not asocial reinforcements facilitated spatial working memory in schizophrenic patients. In experiment 2, the effects of human voice reinforcements (with or without affect) on working memory was investigated. Voice reinforcements did not facilitate working memory relative to the no-reinforcement condition. There was no difference between high-affect vs flat-affect voice conditions. In experiment 3, the effects of direct and indirect social interactions on spatial working memory were studied. Direct but not indirect social interaction facilitated working memory in schizophrenic patients. These results suggest that social context might facilitate working memory in schizophrenic patients perhaps by activating frontal lobe systems. In addition, the possibility of improving cognitive functions such as working memory using seemingly non-cognitive methods might lead to potential remediation strategies.     

Comparative meta-analyses of neuropsychological functioning in antisocial schizophrenic persons

To test the hypothesis that antisocial persons with schizophrenia are characterized by a distinct profile of neurocognitive deficits, meta-analyses of 43 studies were conducted to compare the neuropsychological performance of antisocial schizophrenic individuals to non-antisocial schizophrenic individuals, and to antisocial individuals without schizophrenia. Performance was evaluated across several different domains of neuropsychological functioning for both types of comparisons. Results indicated antisocial schizophrenic individuals demonstrated widespread deficits across multiple domains (Full Scale IQ, Verbal and Performance IQ, attention, broadly-defined executive function, and memory) in comparison to their antisocial counterparts. However, in comparison to their schizophrenic counterparts, persons with antisocial schizophrenia were characterized instead by reduced general intellectual functioning and memory dysfunction (as opposed to hypothesized Verbal IQ and executive function deficits). Findings may suggest a biologically distinct subgroup of antisocial schizophrenic individuals, whose study and treatment require differing approaches from those traditionally used in non-antisocial presentations of schizophrenia.