缓解与未缓解的慢性精神分裂症患者知觉空间分离范式下前脉冲抑制缺陷

Deficits of perceived spatial separation induced prepulse inhibition in remission and non-remission patients with chronic schizophrenia

目的:探索症状缓解与未缓解的慢性精神分裂症患者知觉空间分离的前脉冲抑制(PPI)。方法:采用阳性与阴性症状量表(PANSS)评分将60例慢性精神分裂症患者分为缓解组(34例)与未缓解组(26例);采用惊跳反射测试记录患者知觉空间融合(PSC)或知觉空间分离(PSS)诱导的肌电活动的峰值(PA),计算PSC-PPI及PSS-PPI以及由知觉空间效应造成的前脉冲增量(Enh-PPI),结果与27名正常对照者(正常对照组)比较;分析患者临床症状与PPI的关系。结果:①正常对照组PSC-PPI、PSS-PPI及Enh-PPI明显高于两组患者(P均<0.01);两组患者间差异无统计学意义;②正常对照组内的PSC-PPI与PSS-PPI比较差异有统计学意义(P<0.05);缓解组和未缓解组内部比较差异无统计学意义。③相关分析显示,未缓解组的PSC-PPI和PSS-PPI分别与PANSS总分、阳性症状分及一般精神症状分呈负相关(P均<0.05);缓解组PANSS评分与PSC-PPI、PSS-PPI无相关。结论:慢性精神分裂症患者存在知觉空间分离下PPI缺陷,其缺陷可能既是状态指标也是素质指标。

Objective:To investigate the deficit of prepulse inhibition(PPI)in remission and non-remission patients with chronic schizophrenia using a perceived spatial separation induced PPI.Method:A total of 60 patients(34 cases of remission,26 cases of non-remission)and 27 healthy controls matched with gender,age,and education level were recruited.The positive and negative syndrome scale(PANSS)was used to assess psychopathological symptoms of the patients,all subjects underwent a modified paradigm of prepulseinhibition measurement.The acoustic startle reflex during perceived spatial separation(PSS)and perceived spatial co-location(PSC)was evaluated to record amplitude(PA)of the orbicularis oculi muscle during blinking,then PSS-PPI,PSC-PPI and enhanced PPI(Enh-PPI)were calculated.PPI of the three groups were analyzed via the variance and post hoc test,while relationships between patients'symptoms and PPI was conducted.Results:①The PSC-PPI,PSS-PPI and Enh-PPI in the control group were significantly higher than those in patient groups(P<0.01),but there was no significant difference between patient groups(P>0.05);②In the control group,PSS between the prepulse and noise masker could further enhance PPI compared to the condition when the prepulse and noise masker were perceived spatially co-located.In contrast,the enhancement was impaired in patients.③Further analysis revealed the PSC-PPI and PSS-PPI of the non-remission group were negatively correlated with the total score of PANSS,the score of positive symptoms and the score of general mental symptoms,respectively(all P<0.05).In the remission group,the total score of PANSS had no correlation with PSC-PPI and PSS-PPI.Conclusion:There is a significant deficit of PSC(PSS)-PPI in patients with chronic schiaophrenia,which may be both a state and a trait indicator.