CAJ | 학술논문

目的了解首发精神分裂症患者的执行功能,及其与阴阳性症状之间的关系,探讨患者前额叶激活状态的特点.方法采用电子版伦敦塔(TOL)测试对40名首发精神分裂症患者和40名健康对照进行测试并记录正确回答数,在测试同时使用近红外光谱成像(NIRS)仪监测其前额叶激活度.应用阳性与阴性症状量表(PANSS)评定患者组的阳性与阴性症状.结果 (1)精神分裂症患者组各水平TOL的正确答题数目[1步(7.35±1.94)个,2步(7.30±2.53)个,3步(6.58±2.53)个,4步(2.90±1.89)个]均少于正常组[1步(8.82±1.48)个,2步(8.38±1.59)个,3步(7.68±1.47)个,4步(3.73±1.71)个],均差异具有统计学意义(P＜0.05);(2)精神分裂症患者的TOL完成情况与PANSS中阴性分量表分呈负相关关系(P＜O.05);(3)在TOL测试下,正常组激活了大部分的前额叶;与正常组相比,精神分裂症患者组左侧前额叶激活程度下降.结论发病初期精神分裂症患者存在执行功能障碍,可能与其前额叶功能低下有关;患者的执行功能与其阴性症状呈显著负相关;NIRS可成为研究及临床评估重性精神疾病的有用工具.
목적 료해수발정신분렬증환자적집행공능,급기여음양성증상지간적관계,탐토환자전액협격활상태적특점.방법 채용전자판륜돈탑(TOL)측시대40명수발정신분렬증환자화40명건강대조진행측시병기록정학회답수,재측시동시사용근홍외광보성상(NIRS)의감측기전액협격활도.응용양성여음성증상량표(PANSS)평정환자조적양성여음성증상.결과 (1)정신분렬증환자조각수평TOL적정학답제수목[1보(7.35±1.94)개,2보(7.30±2.53)개,3보(6.58±2.53)개,4보(2.90±1.89)개]균소우정상조[1보(8.82±1.48)개,2보(8.38±1.59)개,3보(7.68±1.47)개,4보(3.73±1.71)개],균차이구유통계학의의(P＜0.05);(2)정신분렬증환자적TOL완성정황여PANSS중음성분량표분정부상관관계(P＜O.05);(3)재TOL측시하,정상조격활료대부분적전액협;여정상조상비,정신분렬증환자조좌측전액협격활정도하강.결론 발병초기정신분렬증환자존재집행공능장애,가능여기전액협공능저하유관;환자적집행공능여기음성증상정현저부상관;NIRS가성위연구급림상평고중성정신질병적유용공구.
Objective To investigate the executive function of the patients with first-episode schizophrenia,and their relationships with the positive and negative symptoms. And to evaluate the activation characteristics of prefrontal cortex(PFC) in the schizophrenia. Methods Near-infrared spectroscopy(NIRS) was used to assess the activation of the bilateral PFCs during the computerized version of Tower of London(TOL) tasks in schizophrenia and controls. The Positive and Negative Syndrome Scale(PANSS) was used to assess the psychiatric symptoms of the schizophrenia. 40 schizophrenic patients and 40 age- and gender-matched healthy subjects participated in this study. Results ( 1 ) The number of correct TOL responses in patients ( one-move ( 7.35 ± 1. 94 ), two-move ( 7.30 ± 2.53 ), three-move ( 6.58 ± 2.53 ), four-move ( 2.90 ± 1.89 ) ) was significantly less than the healthy controls( one-move (8.82 ± 1.48 ), two-move ( 8.38 ± 1.59 ), three-move ( 7.68 ± 1.47 ), four-move ( 3.73 ±1.71 ); P＜0. 05 ). ( 2 ) There was a significant negative correlation between the patients' task performance and the negative symptom scores(P ＜ 0.05 ). (3) The majority of the prefrontal area was activated in health subjects.Patients were characterized by significant decreased activation in the left PFC during the TOL task compared to healthy subjects. Conclusion Schizophrenic patients have executive function disorder at the initial stage of the disease.The results support that schizophrenia patients have hypofrontality ,and executive function is significantly negatively correlated with negative symptoms. NIRS my be a useful tool for research and clinical assessment for major psychoses.