首次发病未服药精神分裂症患者立体视觉与认知功能的相关性研究

Correlation between stereopsis and cognitive function in first-episode drug-naïve patients with schizophrenia

目的研究首次发病未服药精神分裂症患者的立体视觉及其与认知功能的关系。方法本研究起止时间为2019年1月至2020年9月;共招募146例首次发病未服药精神分裂症患者(首发精分组)、124例慢性期精神分裂症患者(慢性精分组)和101名健康对照者(对照组)。采用Titmus方法检测立体视觉,阳性与阴性症状量表评定患者临床症状,重复性成套神经心理状态测验(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS)评估认知功能。采用协方差分析3组间立体视觉和认知功能的差异,Spearman相关和多元线性回归分析立体视觉和临床症状、认知功能的相关性。结果(1)3组间的立体视觉水平和认知功能方面的差异有统计学意义(P<0.01),事后比较分析发现首发精分组、慢性精分组的立体视觉和认知水平分别与对照组差异有统计学意义,而首发精分组和慢性精分组的差异无统计学意义。(2)Spearman相关分析显示,首发精分组的立体视觉水平与临床症状严重程度的相关不显著,但与视觉广度(r=-0.193,P=0.019)、言语功能(r=-0.261,P=0.001)、注意功能(r=-0.168,P=0.042)和RBANS总分(r=-0.236,P=0.004)显著相关。对照组和慢性精分组的立体视觉水平与临床症状严重程度、认知功能相关均不显著。进一步多元线性回归发现,立体视觉对首发精分组的视觉广度(β=-0.213,P=0.011)、言语功能(β=-0.252,P=0.003)、注意功能(β=-0.189,P=0.019)和RBANS总分(β=-0.235,P=0.003)仍有显著的影响。结论首发精分组和慢性精分组均存在显著的立体视觉和认知功能障碍;首发精分组立体视觉的水平与临床症状严重程度相关不显著,但与认知功能相关。

Objective To explore stereoscopic vision and its correlation with cognitive function in first-episode drug-naïve patients diagnosed with schizophrenia(FNPS).Methods A study was conducted from January 2019 to September 2020.A total of 146 FNPS,124 patients with chronic schizophrenia(PCS)and 101 healthy controls(HCs)were recruited.Stereoscopic vision was evaluated by Titumus stereotests.Their clinical symptoms were assessed by positive and negative syndrome scale.Cognitive function was assessed by the repeatable battery for the assessment of neuropsychological status(RBANS).The differences in stereoscopic vision and cognitive function among the three groups were analyzed by analysis of covariance.The Spearman correlation and multiple regression analysis were used to identify the correlation between stereoscopic vision and clinical symptoms or cognitive function.Results(1)There were significant differences in stereoscopic vision and cognitive function among the three groups(P<0.05).After pairwise comparison,it was found that the stereoscopic vision and cognitive functions of FNPS group and PCS group were significantly different from HCs group.However,there were no significant differences in stereoscopic vision and cognitive function between FNPS and PCS groups.(2)Spearman correlation analysis showed that stereoscopic vision was not correlated with the severity of clinical symptoms in FNPS,but it was correlated with visuospatial score(r=-0.193,P=0.019),language score(r=-0.261,P=0.001),attention score(r=-0.168,P=0.042),and RBANS total scores(r=-0.236,P=0.004).Moreover,there was no correlation of stereoscopic vision with the severity of clinical symptoms or cognitive function in HCs and PCS.Further multiple linear regression showed the significant effect of stereoscopic vision on visuospatial score(β=-0.213,P=0.011),language score(β=-0.252,P=0.003),attention score(β=-0.189,P=0.019),RBANS total score(β=-0.235,P=0.003)in FNPS.Conclusions FNPS and PCS show significant impairments in stereoscopic vision and cognitive function.Stereoscopic vision is closely correlated with cognitive function rather than the severity of clinical symptoms in FNPS.