首发精神分裂症患者错误相关负电位变异的初步研究

Preliminary study on variations and neural generators of error-related negativity in first episode schizophrenics

目的探讨首发精神分裂症患者错误相关负电位（ERN）的变异及相应脑激活区。方法在2010年3月至2011年2月，应用德国Brain roducts公司的ERP记录与分析系统，对上海交通大学医学院附属精神卫生中心58例首发精神分裂症患者和62名健康成人做了ERN检测及脑激活部位的比较。结果（1）与健康对照组相比，首发精神分裂症ERN潜伏期在Cz（健康对照组：49ms±13ms，患者组：58ms±14ms，P〈0．01）、Fz（健康对照组：47ms±13ms，患者组：60ms±11ms，P〈0．01）、C3（健康对照组：50ms±14ms，患者组：57ms±17ms，P〈0．05）和C4（健康对照组：51ms±12ms，患者组：60ms±13ms，P〈0．01）上明显延迟，波幅Cz（健康对照组：7．5μV±3．1μV，患者组：5．0μV±2．8μV，P〈0．01）、C3（健康对照组：8．0μV±3．7μV，患者组：5．5μV±4．0μV，P〈0．01）、Fz（健康对照组：7．7μV±3．8μV，患者组：5．0μV±3．1μV，P〈0．01）、Pz（健康对照组：7．5μV±3．0μV，患者组：4．5μV±3．3μV，P〈0．01）较健康对照组低。（2）ERN潜伏期和波幅变化与阳性症状分和PANSS总分之间缺乏显著性相关。（3）精神分裂症组脑岛、颞上回、颞中回、顶下小叶等处激活明显低下。结论（1）首发精神分裂症患者的ERN波幅和潜伏期异常，可能反映了本组患者内在错误监控机制存在缺陷，此特点仍需进一步随访。（2）脑岛等处功能异常导致的精神分裂症错误监控功能障碍，可能是其发病机制之一。

Objective To explore the variations and their activated brain areas of error-related negativity （ERN） in first episode schizophrenics. Methods ERN was tested by an ERP device and their activated brain areas were compared in 58 first episode schizophrenics （FES） and 62 normal controls （NC） from March 2010 to February 2011. Results （ 1 ） The ERN latencies in the FES group were significantly longer on Cz （58±14 ms）, Fz （60±11 ms）, C3 （57±17 ms） and G4 （60±13 ms） electrodes compared with those in the NC group （49±13 ms, 47±13 ms, 50 ±14 ms, 51±12 ms）. And the ERN amplitudes were significantly lower than those in the controls in Cz （5.0 ＋ 2. 8 μV; 7.5±3.1μV, P 〈 0. 01 ） , C3 （5.5±4.0 μV;8.0±3.7μV, P〈0.01）, Fz （5.0±3.1μV;7.7±3.8 μV,P〈0.01） and Pz （4.5±3.3μV： 7. 5±3.0μV, P 〈0. 01 ） electrodes. （2） The variations of ERN latencies and amplitudes showed an insignifieant correlation with the positive symptom scores and total scores of PANSS. （3） The activation levels of insula, superior temporal gyrus, middle temporal gyrus and inferior parietal lobule were obviously lower in the FES group than those in the NC group. Conclusion The anomalies of ERN lateneies and amplitudes in first episode schizophrenics may reflect the deficient error-monitoring functions. Further studies are warranted. And such brain areas as insular may contribute pathogenieally to the dysfunctions of error- monitoring in schizophrenics.