精神分裂症患者注意状态对事件相关电位P300的影响

Influence of schizophrenic's attention state on event-related potential P300

目的探讨精神分裂症(SP)患者注意功能对事件相关电位(ERP)P300的影响,为SP患者的认知功能损害及康复评估寻找电生理依据。方法对研究组45例SP患者和对照组26例健康人在被动注意和选择性注意两状态下进行ERP P300测定。被动注意状态时,指导语为请注意听耳机中出现的声音;选择性注意状态时,指导语为耳机中将出现两种声音,请注意识别高音调的声音,并对高音调的声音进行计数。结果与对照组比较,研究组被动注意状态下ERP各波和选择性注意状态下N2、P3波幅降低,潜伏期延长,差异有统计学意义;选择性注意下的N1、P2波幅和潜伏期,两组比较差异无统计学意义;与选择性注意状态比较,研究组被动注意状态ERP早期成分N1、P2波幅降低,潜伏期延长,差异有统计学意义,后期N2、P3比较差异无统计学意义;对照组两种注意状态下各波潜伏期比较差异无统计学意义,只有P3波幅降低。结论 SP患者有注意功能缺陷,虽然能对选择性注意的早期注意力进行过滤,但是不能维持对后期的处理,注意功能对ERP各波参数有较大影响,ERP可为患者认知功能损害程度和康复水平提供客观的电生理依据。

【Objective】 To explore the influence of schizophrenic’s attention state on event related potential（ERP） P300 in order to search electrophysiological basis for schizophrenic’s cognitive impairment and rehabilitation level. 【Methods】 ERP P300 determinations were conducted in the state of passive and selective attention in 45 schizophrenics（the research group） and 26 healthy subjects（the control group）. Instructions were that ’please listen to sound emerging in earphone carefully’ in the state of passive attention and ’please distinguish high-tone sound from 2 kinds of sounds emerging in earphone carefully and count it’ in that of selective attention. 【Results】 Compared with the control group, each wave amplitude of ERP in the state of passive attention and N2 and P3 in that of selective attention lowered and their latency periods prolonged in the research group, the differences had a statistical significance, and there were no group differences in N1 and P2 amplitude and latency period in the state of selective attention. In the research group N1 and P2 amplitude lowered and latency period prolonged in the early stage in the state of passive attention compared to those in the state of selective attention, with statistical differences, but there were no differences in N2 and P3 in the later stage. In the control group there were no differences in the latency periods of each wave between the passive and selective attention states and only P3 amplitude lowered. 【Conclusion】 Schizophrenics have attention deficit, even if they could filter early attention of elective attention, they don’t maintain latter processing. Attention has great influences on each wave parameters of ERP. ERP could provide objective electrophysiological basis for schizophrenic’s cognitive impairment and rehabilitation level.