事件相关电位与初发和复发精神分裂症临床症状的关系

Correlation between variations of event-related potentials and clinical symptoms of patients with first-episode schizophrenia and recur schizophrenia

目的研究初发精神分裂症(FSZ)和复发精神分裂症(RSZ)患者事件相关电位变异与临床症状的关系,探讨变异性质及相关机制。方法应用Bravo脑电生理仪及听觉靶-非靶刺激序列技术对96例FSZ、118例RSZ及110名健康成人进行P3检测,并用阳性和阴性症状量表(PANSS)评定患者精神症状。病例组于治疗6周时进行P3随访。结果在Cz脑区中,FSZ和RSZ患者P3潜伏期延迟及波幅降低与阳性症状分和PANSS总分呈负相关。3组在靶潜伏期N2、P3及非靶P2,波幅P3和非靶波幅P2上的差异有统计学意义(P<0.05或P<0.01)。与正常对照组相比,FSZ和RSZ潜伏期N2和P3延迟,P3波幅降低(P<0.05或P<0.01)。与FSZ相比,RSZ非靶P2延迟,非靶P2波幅下降(P<0.05)。治疗后P3中靶波幅P3的恢复仅见于FSZ患者,不见于RSZ患者。RSZ患者P3的P3波幅,在治疗干预后明显恢复不良。对FSZ和RSZ患者的随访结果显示:P3中潜伏期N2和P3延迟可能属于该疾病的属性标志;而靶波幅P2和P3下降可能属于该疾病的状态标志。结论本病在发病初期存在认知功能缺陷,这种认知缺陷可能对患者今后的发病、治疗效果和社会功能会产生影响。随访结果提示本病P3变化是混合性标志。

Objective To investigate the correlation between variations of event-related potentials and clinical symptoms of patients with first-episode schizophrenia （FSE） and recur schizophrenia （RSZ）, features of variations, and relevant mechanisms. Methods P3 values of 96 patients with FSE （FSE group）, 118 patients with RSE （RSE group）, and 110 controls （control group） were measured by Brova cerebral electrophysiological instrument and auditory target-non target stimulus sequence technique. Psychotic symptoms of patients were assessed by the positive and negative syndrome scale （ PANSS）. P3 values of the case group were followed up after being treated for 6 weeks. Results The prolonged latency and decreased amplitude of P3 in Cz brain region of patients with FSZ and RSZ negatively correlated with the score of positive syndrome and total score of PANSS. For target latency of N2, P3, and non target P2, the differences of amplitudes of P3 and non target P2 of three groups were statistically significant （P〈0.05, P〈0.01）. Compared with the control group, latencies of N2 and P3 of the FSZ group and RSZ group delayed and amplitudes of P3 decreased （P〈0.05, P〈0.01）. Compared with the FSZ group, non target P2 of the FSZ group delayed and the amplitude of non target P2 decreased （P〈0.05） . The amplitude of target P3 of the FSZ group recovered after treatment, while that of the RSZ group didn＇t recover. The amplitude of P3 of the RSZ group recovered poorly after treatment. Follow up results of patients with FSZ and RSZ showed that delayed latencies of N2 and P3 might be feature markers of the disease, while decreased amplitudes of target P2 and P3 might be state markers of the disease. Conclusion Cognitive deficits can be found at the onset of schizophrenia, which may affect the future incidence, therapeutic effect, and society function. Follow up results indicate that changes of P3 may be mixed markers of schizophrenia.