Cadenhead K S, Light G A, Geyer M A, Braff D L
Department of Psychiatry, University of California, San Diego 92093-0804, USA.
Am J Psychiatry. 2000 Jan;157(1):55-9. doi: 10.1176/ajp.157.1.55.
The schizophrenia spectrum includes individuals with schizophrenia, their relatives, and individuals with schizotypal personality disorder. Subjects in the schizophrenia spectrum have disorders of attention, cognition, and information processing. Attention and information processing can be assessed by testing suppression of the P50 event-related potential; the amplitude of the P50 wave is measured in response to each of two auditory clicks. In normal subjects, the P50 wave following the second click is suppressed, or "gated." Schizophrenic patients and their relatives show less suppression of the second P50 wave. Deficits in P50 suppression have high heritability and show linkage to the alpha-7 subunit of the nicotinic cholinergic receptor gene in families with schizophrenia, suggesting that deficits in P50 suppression are trait markers for gating abnormalities in schizophrenia spectrum subjects. Although schizotypal subjects have been shown to have deficits in sensorimotor gating as measured by prepulse inhibition, to the authors' knowledge P50 sensory gating in schizotypal personality disorder has yet to be reported.
P50 suppression in 26 subjects with schizotypal personality disorder and 23 normal subjects was assessed through auditory conditioning and testing.
The subjects with schizotypal personality had significantly less P50 suppression than did the normal subjects.
Subjects with schizotypal personality disorder may have trait-linked sensory gating deficits similar to those in patients with schizophrenia and their relatives. Because these subjects may manifest sensory gating deficits without overt psychotic symptoms, it is likely that these deficits represent a core cognitive dysfunction of the schizophrenia spectrum.
精神分裂症谱系包括精神分裂症患者、他们的亲属以及分裂型人格障碍患者。精神分裂症谱系中的个体存在注意力、认知和信息处理方面的障碍。注意力和信息处理可通过测试P50事件相关电位的抑制来评估;P50波的振幅是针对两次听觉点击中的每一次进行测量的。在正常受试者中,第二次点击后的P50波会被抑制,即“闸门控制”。精神分裂症患者及其亲属对第二次P50波的抑制作用较弱。P50抑制缺陷具有较高的遗传性,并且在精神分裂症家族中与烟碱型胆碱能受体基因的α-7亚基存在连锁关系,这表明P50抑制缺陷是精神分裂症谱系受试者门控异常的特质标记。尽管已经证明分裂型受试者通过预脉冲抑制测量存在感觉运动门控缺陷,但据作者所知,分裂型人格障碍中的P50感觉门控尚未见报道。
通过听觉条件化和测试评估26例分裂型人格障碍患者和23名正常受试者的P50抑制情况。
分裂型人格障碍患者的P50抑制明显低于正常受试者。
分裂型人格障碍患者可能具有与精神分裂症患者及其亲属类似的与特质相关的感觉门控缺陷。由于这些受试者可能在没有明显精神病症状的情况下表现出感觉门控缺陷,这些缺陷很可能代表了精神分裂症谱系的核心认知功能障碍。