Braff D L, Swerdlow N R, Geyer M A
Department of Psychiatry, University of California, San Diego, La Jolla 92093-0804, USA.
Am J Psychiatry. 1999 Apr;156(4):596-602. doi: 10.1176/ajp.156.4.596.
Information processing, inhibitory, and gating deficits in human and animal model studies of schizophrenia are demonstrated by using prepulse inhibition of the startle reflex. Prepulse inhibition deficits in schizophrenic patients correlate with core cognitive symptoms, such as thought disorder and distractibility, but their relationship to positive and negative symptoms of schizophrenia is less clear.
Fifty-one male schizophrenic patients and 26 male normal comparison subjects were tested for prepulse inhibition of the eyeblink component of the startle reflex measured by electromyogram recording. Startling stimuli (118 dB) were presented alone (pulse only) or were preceded 60 msec by discrete prepulse stimuli of 2, 4, 8, or 16 dB above the background 70-dB noise level. In addition, patients were assessed for demographic variables, generalized symptoms (Brief Psychiatric Rating Scale), and positive and negative symptoms.
Schizophrenic and comparison groups differed significantly in the amount of prepulse inhibition produced by the 16-dB prepulse, with schizophrenic patients showing the expected deficient prepulse inhibition. Latency of the eyeblink response was generally slower for the schizophrenic patients, but the prepulse-induced latency facilitation for schizophrenic patients and comparison subjects did not differ significantly. The pattern of prepulse inhibition deficits in schizophrenic patients remained, with age and education controlled, in an analysis of covariance and subgroup matching. Deficient prepulse inhibition correlated with both positive and negative symptoms of schizophrenia.
Under these experimental conditions, schizophrenia-linked deficits in prepulse inhibition detected with a relatively strong prepulse are correlated with both positive and negative symptoms of schizophrenia. The level of correlation, while significant in this cohort, is not as robust as that in previous reports linking prepulse inhibition deficits with other measures, such as thought disorder. Future work should probably focus on the relationship of prepulse inhibition deficits to measures such as thought disorder rather than positive and negative symptoms.
在精神分裂症的人类和动物模型研究中,通过惊吓反射的预脉冲抑制来证明信息处理、抑制和门控缺陷。精神分裂症患者的预脉冲抑制缺陷与核心认知症状相关,如思维紊乱和注意力分散,但它们与精神分裂症的阳性和阴性症状的关系尚不清楚。
对51名男性精神分裂症患者和26名男性正常对照受试者进行测试,通过肌电图记录测量惊吓反射眨眼成分的预脉冲抑制。单独呈现惊吓刺激(118分贝)(仅脉冲),或在背景70分贝噪声水平之上2、4、8或16分贝的离散预脉冲刺激之前60毫秒呈现。此外,对患者进行人口统计学变量、一般症状(简明精神病评定量表)以及阳性和阴性症状的评估。
精神分裂症组和对照组在16分贝预脉冲产生的预脉冲抑制量上有显著差异,精神分裂症患者表现出预期的预脉冲抑制缺陷。精神分裂症患者的眨眼反应潜伏期通常较慢,但精神分裂症患者和对照受试者的预脉冲诱导潜伏期促进作用没有显著差异。在协方差分析和亚组匹配中,控制年龄和教育因素后,精神分裂症患者的预脉冲抑制缺陷模式仍然存在。预脉冲抑制不足与精神分裂症的阳性和阴性症状均相关。
在这些实验条件下,用相对较强的预脉冲检测到的与精神分裂症相关的预脉冲抑制缺陷与精神分裂症的阳性和阴性症状均相关。这种相关性水平在该队列中虽显著,但不如先前将预脉冲抑制缺陷与其他指标(如思维紊乱)联系起来的报告中的相关性强。未来的工作可能应侧重于预脉冲抑制缺陷与思维紊乱等指标的关系,而非阳性和阴性症状。