遗传负荷对精神分裂症患者认知功能的影响

Effect of genetic loading on cognitive function in schizophrenia

目的 研究精神分裂症单发家系和高发家系患者及其亲属的认知功能,探讨遗传负荷对精神分裂症患者认知功能的影响.方法 使用威斯康星卡片分类测验（WCST）、修订韦氏成人智力量表（WAIS-R）的词汇测验（VS）、多维记忆评估量表（MMAS）的数字广度、汉词广度和空间广度测验及持续注意测验（CPT）对精神分裂症单发家系患者组（21例）及其一级亲属（单发家系亲属组,55例）,高发家系患者组（30例）及其一级亲属（高发家系亲属组,26例）,对照家系组（14名）及其一级亲属（对照家系亲属组,29名）进行研究.结果 高发家系患者组和高发家系亲属组的VS[（9.3±3.9）分vs（13.6±2.2）分和（10.7±4.0）分vs（13.9±2.3）分]和部分记忆广度成绩均明显低于对照家系组分及对照家系亲属组,其WCST卡片总数、持续错误数[（27.9±13.0）分vs（18.3±8.4）分和（26.0±16.3）分vs（18.3±8.7）分]和随机错误数及CPT视觉、听觉漏报数和反应时间均明显多于对照家系组分和对照家系亲属组分,差异有统计学意义（ANOVA,P＜0.05）;单发家系患者组CPT视觉漏报[（68.7±18.4）分vs（49.0±3.4）分]和反应时间、听觉错报和漏报多于对照家系组,差异有统计学意义（ANOVA,P＜0.05）,单发家系亲属组的VS低于对照家系亲属组[（12.0±3.9）分vs（13.9±2.3）分],WCST卡片总数多于对照家系亲属组,差异有统计学意义（ANOVA,P＜0.05）.结论 精神分裂症高发家系认知成绩最差,单发家系患者及亲属大部分认知成绩介于高发家系和对照家系之间;随着遗传负荷的增加,患者及亲属的认知缺陷更为明显,认知功能缺陷可能是精神分裂症遗传易感性的标志之一.

Objective By exploring cognitive function in schizophrenic patients and their relatives from simplex families and multiplex families, to identify the affect of genetic loading on cognitive function in schizophrenia. Methods Twenty-one schizophrenic patents and their 55 first-degree nonpsychotic relatives from simplex families （one family member with schizophrenia） ,21 schizophrenic patients and their 26 firstdegree nonpsychotic relatives from multiplex families （ at least two family members with schizophrenia）, 14matched controls and their 29 first-degree relatives were assessed with the Wisconsin Card Sorting Test （WCST）, vocabulary subtest （VS） of Wechsler Adult Intelligence Scale-revised （WAIS-R）, memory span subtests （MS） of Multiple Memory Assessment Scale （MMAS） and Continuous Perfomance Test （CPT）.Results Compared with controls and their relatives, the patients and their relatives from multiplex families showed significantly worse VS score [ （9. 3 ± 3.9） vs （ 13.6 ± 2. 2 ）, （ 10. 7 ± 4. 0） vs （ 13. 9 ± 2. 3 ）; ANOVA,P〈0.05], more WCST total cards, perseverative errors [（27.9 ± 13.0） vs （ 18.3 ± 8.4）, （26.0 ±16. 3） vs （ 18. 3 ± 8.7）; ANOVA, P 〈 0. 05 ] and random errors, more visaul and acoustic omission, longer visaul and acoustic reaction time respectively（P 〈 0. 05 ）. The patients from simplex families showed more visaul omission [ （68.7 ± 18. 4） vs（49. 0 ±3.4） ;ANOVA,P 〈0. 05] and acoustic omission, acoustic errors and longer visaul reaction time than those for controls significantly （ P 〈 0. 05 ）. The relatives from simplex families only showed worse score of VS [ （ 12. 0 ± 3.9 ） vs （ 13.9 ± 2. 3 ）; ANOVA, P 〈 0. 05 ], more total cards in WCST than those for relatives of controls （P 〈0.05）. Conclusions The cognitve impairments in schizophrenic patients and their relatives aggravate as the degree of genetic loading increases. Cognitive impairments may be potential endophenotypes of familial vulnerability to schizophrenia.