Sharma T
Clinical Neuroscience Research Centre, Dartford, UK.
Curr Med Res Opin. 2002;18 Suppl 3:s13-7. doi: 10.1185/030079902125001074.
Cognitive dysfunction is recognised as one of the more enduring deficits in schizophrenia. The syndrome is associated with impairment of the temporal and frontal regions of the brain that are concerned with cognitve function, as well as subcortical regions that are closely interconnected with them. Cognitive dysfunction may underpin some of the psychopathology of schizophrenia, as well as contribute to the patient's impaired social and vocational functioning. Cognitive deficits are relatively independent of psychotic symptoms in schizophrenia, and are probably central and enduring features of the disorder. It must also be considered that cognitive disability may be rate-limiting to the schizophrenic patient's rehabilitation and impairs quality of life. Although there is a general consensus that neuroleptic drugs are able to improve the psychopathology of schizophrenia, there is continued debate concerning their impact on cognitve function. Chronic treatment with classical neuroleptics has been reported to produce only minimal improvement in, and may actually impair, cognitive function in schizophrenia. In contrast, novel antipsychotics seem to cause less cognitive impairment than classical antipsychotic medication and may improve cognitive function. Whilst in the past research focused on the development of clinically effective antipsychotic drugs with a reduced propensity to cause extrapyramidal symptoms (EPS), it is now being recognised that maintaining and enhancing cognitive function and improving quality of life should be the goal in the treatment of schizophrenia.
认知功能障碍被认为是精神分裂症中较为持久的缺陷之一。该综合征与大脑中与认知功能相关的颞叶和额叶区域以及与之紧密相连的皮质下区域的损伤有关。认知功能障碍可能是精神分裂症某些精神病理学的基础，也会导致患者社会和职业功能受损。精神分裂症中的认知缺陷相对独立于精神病性症状，可能是该疾病的核心和持久特征。还必须考虑到，认知残疾可能是精神分裂症患者康复的限速因素，并损害生活质量。虽然人们普遍认为抗精神病药物能够改善精神分裂症的精神病理学，但关于它们对认知功能的影响仍存在持续的争论。据报道，使用经典抗精神病药物进行长期治疗在精神分裂症的认知功能方面仅产生极小的改善，甚至可能实际上损害认知功能。相比之下，新型抗精神病药物似乎比经典抗精神病药物引起的认知损害更少，并且可能改善认知功能。虽然过去的研究集中在开发临床上有效的抗精神病药物，以降低引起锥体外系症状（EPS）的倾向，但现在人们认识到，维持和增强认知功能以及改善生活质量应该是精神分裂症治疗的目标。
