精神分裂症感觉门控电位P50和惊跳反射弱刺激抑制的相关性

Correlation between P50 auditory sensory gating and prepulse inhibition in patients with schizophrenia

目的:探讨精神分裂症患者感觉门控电位P50和惊跳反射弱刺激抑制(PPI)的特征以及两者的相关性。方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)的精神分裂症患者78例,正常对照90例,使用阳性和阴性症状量表(PANSS)评定精神分裂症患者的临床精神病理症状;使用脑电生理记录仪,采用听觉条件(S1)-测试(S2)刺激范式进行P50检测;使用SR-HLAB惊跳反射监控系统测查听觉惊跳反射。结果:精神分裂症组的S1波幅低于对照组[(2.9±1.7)μV vs.(3.7±2.0)μV,P<0.05];S2波幅高于对照组[(2.0±1.2)μV vs.(1.4±1.5)μV,P<0.001];P50抑制率比值(S2/S1)精神分裂症组高于对照组[(0.8±0.5)vs.(0.4±0.4),P<0.001],P50抑制率差值(S1-S2)低于对照组[(0.9±1.7)vs.(2.3±1.8),P<0.001]。精神分裂症组的惊跳反射的波幅低于对照组[(1037.5±1048.6)ms vs.(1367.7±952.3)ms,P<0.001],习惯化百分比亦低于对照组[(33.9±20.8)%vs.(48.8±34.7)%,P=0.002];精神分裂症组的PPI60和PPI120均低于对照组[(24.1±9.1)%vs.(29.8±11.5)%,P=0.020;(31.2±10.1)%vs.(42.6±15.4)%,P<0.001]。在精神分裂症组中,P50各项分析指标与PPI各项分析指标间的相关性无统计学意义(P>0.05),P50与PPI各项分析指标与PANSS总分、PANSS阳性症状总分、PANSS阴性症状总分间的相关性无统计学意义(P>0.05);在对照组中,惊跳反射的波幅与s1波幅与s2波幅呈正相关(r=0.28、0.27,均P<0.05)。结论:精神分裂症患者可能存在感觉门控的缺陷,P50和PPI缺陷与临床精神病理症状的严重程度可能无关,反映感觉门控的两种测量模式P50和PPI间可能无相关性,二者可能相互独立。

Objective: To investigate the correlation between P50 auditory sensory gating( P50) and prepulse inhibition( PPI) and the characteristic of them in patients with schizophrenia. Methods: Seventy-eight patients with schizophrenia and ninety normal healthy volunteers were recruited. All patients met the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition( DSM-IV) criteria for schizophrenia. The symptoms were assessed with the Positive and Negative Syndrome Scale( PANSS). P50 was measured using the conditioning / testing paradigm presented with auditory double clicks stimuli. Using SR-HLAB monitoring system to detect the auditory startle reflex. Results: Patients had a significant lower P50- S1 amplitude [( 2. 9 ± 1. 7) μV vs.( 3. 7 ± 2. 0) μV,P = 0. 017]and P50 suppression difference( S1- S2) [( 0. 9 ± 1. 7) vs.( 2. 3 ± 1. 8),P < 0. 01]. P50- S2 amplitude [( 2. 0 ±1. 2) μV vs.( 1. 4 ± 1. 5) μV,P < 0. 001] and P50 suppression ratio scores( S2 / S1) [( 0. 8 ± 0. 5) vs.( 0. 4 ± 0. 4),P < 0. 001] were significant higher in patients than in the controls. Compared to the controls,patients had significant lower PPI60 [( 24. 1 ± 9. 1) % vs.( 29. 8 ± 11. 5) %, P = 0. 020 ] and PPI120 [( 31. 2 ± 10. 1) % vs.( 42. 6 ±15. 4) %,P < 0. 001 ] as well as the amplitude of auditory startle reflex [( 1037. 5 ± 1048. 6) ms vs.( 1367. 7 ±952. 3) ms,P < 0. 001 ] and habituation% [( 33. 9 ± 20. 8) % vs.( 48. 8 ± 34. 7) %,P = 0. 002]. In patients,there was no a correlation between P50 and PPI( P > 0. 05). In the controls, the amplitude of auditory startle reflex showed a weak positive correlation with P50- S1 amplitude and P50- S2 amplitude( r = 0. 275,P = 0. 009 and r =0. 265,P = 0. 012 respectively). The bivariate correlation between the indicators of P50 or PPI and PANSS-total,PANSS-positive,PANSS-negative symptoms was not statistically significant( P > 0. 05). Conclusion: Patients with schizophrenia may present the deficits of the sensory gating. The deficits of sensory gating in schizophrenic patients may be not association with clinical symptoms of psychopathology,and it is possible that there is no correlation between P50 and PPI,suggesting that they may be irrelevant with each other.