CAJ | 학술논문

目的探讨喹硫平对儿童少年期精神分裂症患者事件相关电位失匹配性负波(MMN)的影响.方法选择6～15岁符合DSM-IV精神分裂症标准的患者23例作为研究组,23例正常儿童少年作为对照组.研究组于喹硫平治疗前、4周后以及8周后予MMN 检测,同时予PANSS评定病情严重程度.对照组入组时预MMN 检测.观察MMN波幅、潜伏期的变化.结果研究组在治疗4周后以及8周后PANSS量表分低于基线水平(均P <0.05).研究组频率偏离MMN波幅及持续时间偏离MMN波幅[分别为(1.57 ±0.9)μV、(1.53±0.8)μV]均低于对照组[分别为(2.01±0.4)μV、(2.00±0.86)μV](均P <0.05).将MMN型与治疗时间层面作为组间因素的重复测量的方差分析显示,研究组频率偏离MMN与持续时间偏离MMN2组波幅间交互作用不显著(F =0.704,dF =1,P =0.403);MMN型与治疗时间层面交互作用不显著(F =0.299,dF =2,P =0.796);治疗时间层面间存在显著效应(F =3.576,dF =2,P =0.031).治疗8周后MMN波幅[分别为(1.94 ±0.5)μV、(1.88±0.7)μV]比基线水平、治疗4周后[分别为(1.65 ±0.8)μV、(1.42±0.7)μV]明显升高(P =0.025、0.020).结论儿童少年期精神分裂症患者认知功能损害,MMN提供了喹硫平能够改善儿童少年期精神分裂症认知功能的证据.
목적 탐토규류평대인동소년기정신분렬증환자사건상관전위실필배성부파(MMN)적영향.방법 선택6～15세부합DSM-IV정신분렬증표준적환자23례작위연구조,23례정상인동소년작위대조조.연구조우규류평치료전、4주후이급8주후여MMN 검측,동시여PANSS평정병정엄중정도.대조조입조시예MMN 검측.관찰MMN파폭、잠복기적변화.결과 연구조재치료4주후이급8주후PANSS량표분저우기선수평(균P <0.05).연구조빈솔편리MMN파폭급지속시간편리MMN파폭[분별위(1.57 ±0.9)μV、(1.53±0.8)μV]균저우대조조[분별위(2.01±0.4)μV、(2.00±0.86)μV](균P <0.05).장MMN형여치료시간층면작위조간인소적중복측량적방차분석현시,연구조빈솔편리MMN여지속시간편리MMN2조파폭간교호작용불현저(F =0.704,dF =1,P =0.403);MMN형여치료시간층면교호작용불현저(F =0.299,dF =2,P =0.796);치료시간층면간존재현저효응(F =3.576,dF =2,P =0.031).치료8주후MMN파폭[분별위(1.94 ±0.5)μV、(1.88±0.7)μV]비기선수평、치료4주후[분별위(1.65 ±0.8)μV、(1.42±0.7)μV]명현승고(P =0.025、0.020).결론 인동소년기정신분렬증환자인지공능손해,MMN제공료규류평능구개선인동소년기정신분렬증인지공능적증거.
Objective To study the mismatch negativity potentials effects of quetipine treatment on childhood and adolescent schizophrenia. Methods 23 patients (among 6'15 years old) met with DSM-IV for schizophrenia criteria were enrolled as research group and 23 healthy children and adolescents were selected as normal control group that performed the frequency and duration deviant MMN task. MMN latency and amplitude at Fz electrodes were obtained. The research group was treated with quetipine for 8 weeks and assessed with PANSS. MMN amplitudes and latencies of all groups were compared with each other respectively. Result Quetipine decreased all PANSS scales(P <0.05). Patients showed smaller mean amplitudes of frequency and duration MMN[(1.57 ±0.9)μV,(1.53±0.8)μV respectively] than controls[(2.01 ±0.4)μV,(2.00±0.86)μV respectively](P <0.05). A two-way repeated measures ANOVA with MMN type (frequency vs. Duration) and session as between-subject factors revealed no significant MMN type or MMN type ×session interaction for MMN amplitudes (for MMN type:F =0.704,dF =1,P =0.403; for MMN type ×session:F =0.299,dF =2,P =0.796) and significant effects of session(F =3.576,dF =2,P =0.031). A multiple comparisons by LSD tests demonstrated significant differences between MMN amplitudes at after 8-week treatment and at baseline (P =0.025) or at 4-week treatment (P =0.020) and no significant differences between MMN amplitudes at after 4-week treatment and at baseline (P =0.935). MMN amplitudes at 8-week treatment[(1.94 ±0.5)μV,(1.88±0.7)μV respectively] are higher than at 4-week treatment[(1.65 ±0.8)μV,(1.42±0.7)μV respectively]and at baseline(P <0.05).Conclusions It presents cognitive dysfunction in childhood and adolescent schizophrenia.In neuroelectrophysical aspect,MMN offers objective evidence that treatment with the Quetiapine improves cognitive function in childhood and adolescent schizophrenia.