伴和不伴有凶杀行为的精神分裂症患者听觉感觉门控P50的研究

目的 分析伴和不伴有凶杀行为的精神分裂症患者听觉感觉门控P50的变化及其意义.方法 应用256导联高密度脑电仪采用听觉条件(S1)-测试刺激(S2)模式对26例具有凶杀行为的精神分裂症患者(凶杀组)、27例非凶杀行为的精神分裂症患者(非凶杀组)和32名正常对照者(正常组)进行听觉诱发电位P50检测.应用阳性和阴性症状评定量表(PANSS)对患者进行临床精神症状评定.结果 (1)与正常组相比,凶杀组、非凶杀组S1-P50的波幅[Fz脑区分别为(2.4±1.6)μV、(2.5±1.5)μV和(3.4±2.7)μV和潜伏期[Fz脑区分别为(68±19)ms、(67±20)ms和(61±19)ms]差异均无统计学意义(均P＞0.05),s2.P50波幅高[Fz脑区分别为(0.8±0.7)μV、(2.5 ±1.6)μV和(3.3±2.2)μV]和潜伏期延迟[Fz脑区分别为(50 4±26)ms、(75±19)ms和(70±24)ms](均P＜0.01);凶杀组和非凶杀组的s2-P50波幅和潜伏期差异均无统计学意义(均P＞0.05).(2)与正常组相比,凶杀组、非凶杀组的S2/S1比值高[Fz脑区分别为35±26、153±137和125±85],S1-S2差值小[Fz脑区分别为1.69 ±1.55、0.08 ±2.41和0.17±2.30]和100(1-S2/S1)值小[Fz脑区分别为65 ±26、-53 ±137和-25 ±85](P＜0.01).而凶杀组和非凶杀组的S2/S1比值、S1-S2差值和100(1-S2/S1)差异均尤统计学意义(均P＞0.05).(3)凶杀组和非凶杀组的PANSS总分、阳性量表总分、阴性量表总分及一般精神病理量表总分的差异均无统计学意义[凶杀组分别为:(110 ±27)分、(26±10)分、(29±7)分、(55±12)分;非凶杀组分别为:(105 ±27)分、(24 ±8)分、(28±10)分、(53 ±12)分](均P＞0.05),且与反映P50的S/S1、S1-S2差值和100(1-S2/S1)指标的相关性差异均无统计学意义(均P＞0.05).结论 伴和不伴有凶杀行为的精神分裂症患者感觉门控存在异常,能通过听觉P50检测,但P50指标无差异.

Sensory gating P50 in schizophrenic patients with and without homicide

Objective To investigate the change of sensory gating P50 in schizophrenic patients with and without homicide.Methods The auditory evoked potentials P50 were recorded from 26schizophrenic patients with homicide(Sch group),27 schizophrenic patients without homicide(non-Schgroup)and 32 normal controls(NC)using conditioning/testing paradigm presented with auditory double click stimuli bv EGI 256 dense array.And the same time,their clinical symptoms were evaluated by positive and negative symptom scale(PANSS).Results (1)Compared with NC,two Sch groups showed no significant difference in amplitude and latency of S1-P50[amplitude:NC,Sch group,non-Sch group at Fz:(2.4 ±1.6)μV,(2.5 ±1.5)μV,(3.4±2.7)μV;latency:NC,Sch group,non-Sch group at Fz:(68 ±19)ms,(67 ±20)ms,(61 ±19)ms;respectively],but a higher amplitude and delayed latency of S2-P50[amplitude:Nc,Sch group,non-Sch group at Fz:(0.8 ±0.7)μV,(2.5 ±1.6)μV,(3.3 ±2.2)μV;latency:NC,Sch group,non-Sch group at Fz:(50 ±26)ms,(75 ±19)ms and(70 ±24)ms respectively] (P＜0.01),and no significant difference in amplitude and latency of S2-P50 between two Sch groups.(2)Compared with NC,two Sch groups showed a higher S2/S1 ratio[NC,Sch group,non-Sch group at Fz:35±26,153±137,125 ±85,respectively],lower S2-S1[NC,Sch group,non Sch group at Fz:1.69 ±1.55,0.08 ±2.41 and 0.17 ±2.30,respectively]and 100(1-S2/S1)[NC,Sch group,non-Sch group at Fz:65±26,-53±137 and -25±85 respectively](P＜0.01).And there was no significant difference in S2/S1 ratio,S2-S1 and 100(1-S2/S1)between two Sch groups.(3)Two Sch groups showed no significant difference in PANSS total,P scale,N scale,and G scale[Sch group:(110 ±27),(26 ±10),(29±7),(55±12);non Sch group:(105±27),(24±8),(28±10)and(53 ±12)respectively](P＞0.05),and no significant correlation with S2/S1 ratio,S2-S1 and 100(1-S2/S1)(P＞0.05).Conclusion Sensory gating deficit exists in schizophrenic patients with and without homicide.And it can be quantified by measuring auditory evoked potential P50,but sensory gating P50 has no difference between schizophrenic patients with and without homicide.