CAJ | 학술논문

目的比较精神分裂症患者与健康人在不同难度等级伦敦塔(the Tower of London,TOL)认知任务下的脑区激活程度和模式的差异.方法利用功能性近红外光谱成像技术(functional near infrared spectroscopy,fNIRS),记录30例精神分裂症患者(患者组)和30名健康对照(对照组)在fNIRS仪不同难度等级的TOL任务下双侧前额叶皮质血红蛋白浓度的变化；以阳性与阴性症状量表评分评定患者组的精神症状.结果 (1)患者组较对照组在各难度等级的TOL测验上的正确答题数少,反应时间长(P均＜0.05).(2)激活程度比较:患者组在各难度等级TOL任务下前额叶皮质激活均弱于对照组(P＜0.05).(3)激活模式比较:中间的前额叶皮质:对照组的激活程度为中等任务＞容易任务＞困难任务[容易、中等及困难任务期氧合血红蛋白的差值(△oxy-Hb)分别为4.05±4.89、5.93±3.94、2.12±1.78,P＜0.05],患者组不同难度TOL任务下激活程度差异无统计学意义(P＞0.05)；背外侧前额叶皮质:对照组不同难度TOL任务下激活程度差异无统计学意义(P＞0.05),患者组随着任务难度的增加其激活程度降低(容易、中等及困难任务期△oxy-Hb分别为5.19±9.12、3.14±6.74、0.01±0.82,P ＜0.05).结论精神分裂症患者存在前额叶功能低下,其在任务状态下的激活模式与健康人不同.
목적 비교정신분렬증환자여건강인재불동난도등급륜돈탑(the Tower of London,TOL)인지임무하적뇌구격활정도화모식적차이.방법 이용공능성근홍외광보성상기술(functional near infrared spectroscopy,fNIRS),기록30례정신분렬증환자(환자조)화30명건강대조(대조조)재fNIRS의불동난도등급적TOL임무하쌍측전액협피질혈홍단백농도적변화；이양성여음성증상량표평분평정환자조적정신증상.결과 (1)환자조교대조조재각난도등급적TOL측험상적정학답제수소,반응시간장(P균＜0.05).(2)격활정도비교:환자조재각난도등급TOL임무하전액협피질격활균약우대조조(P＜0.05).(3)격활모식비교:중간적전액협피질:대조조적격활정도위중등임무＞용역임무＞곤난임무[용역、중등급곤난임무기양합혈홍단백적차치(△oxy-Hb)분별위4.05±4.89、5.93±3.94、2.12±1.78,P＜0.05],환자조불동난도TOL임무하격활정도차이무통계학의의(P＞0.05)；배외측전액협피질:대조조불동난도TOL임무하격활정도차이무통계학의의(P＞0.05),환자조수착임무난도적증가기격활정도강저(용역、중등급곤난임무기△oxy-Hb분별위5.19±9.12、3.14±6.74、0.01±0.82,P ＜0.05).결론 정신분렬증환자존재전액협공능저하,기재임무상태하적격활모식여건강인불동.
Objective To investigate the executive function as well as the characteristics of the activation in the prefrontal cortex (PFC) of schizophrenia patients during the graded Tower of London test.Methods Near-infrared spectroscopy (NIRS) was used to assess hemoglobin concentration changes in the bilateral PFCs during the TOL tasks (at different levels of difficulty) in 30 schizophrenia patients and 30 age-and gender-matched healthy controls.The Positive and Negative Syndrome Scale (PANSS) was used to assess the psychiatric symptoms of the patients.Results (1) The numbers of the correct answers of all the three difficulty levels of TOL in the schizophrenia group were less than that of the control group,while the response time were longer than that of the latter.(2) The majority of the prcfrontal areas of the normal controls were significantly activated during TOL task.And compared with the controls,the patients were characterized by significant decreased activation in the bilateral PFC during all levels of the TOL tasks (P ＜0.05).(3) The activation patterns of the two groups were different.The activations in middle areas of the prefrontal cortex in the normal controls were medium ＞ easy ＞ difficult (the △oxy-Hb of easy,medium and difficult were 4.05 ±4.89,5.93 ±3.94 and 2.12 ± 1.78 respectively,P ＜0.05).In the patients,there was no significant difference among the different levels of TOL (P ＞ 0.05).There was no differences on activations in dorsolateral prefrontal cortex in the normal controls among the different levels of TOL (P ＞0.05),while for the patients,with the increasing of the difficulty of the TOL tasks,the activations were reduced instead (the Aoxy-Hb of easy,medium and difficult were 5.19 ± 9.12,3.14 ± 6.74 and 0.01 ±0.82 respectively,P ＜ 0.05).Conclusion Schizophrenia patients have executive dysfunction,which may be explained by PFC dysfunction.The results further support that schizophrenia patients have hypofrontality,and different activation model during executive tasks.