Danckert James, Saoud Mohamed, Maruff Paul
Canada Research Chair (Tier II) in Cognitive Neuroscience, Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada N2L 3G1.
Schizophr Res. 2004 Oct 1;70(2-3):241-61. doi: 10.1016/j.schres.2003.12.007.
Many recent models of schizophrenia have attempted to explain the so-called first-rank symptoms in terms of a breakdown in the self-monitoring of thoughts and behaviours. These models have focused on the most common symptom of schizophrenia auditory hallucinations-suggesting that they may represent disordered self-monitoring of internal speech. As such, much attention has been given to the role of the temporal and frontal cortices in the clinical presentation of patients with schizophrenia. In this review, we examine the role of the posterior parietal cortex (PPC) in schizophrenia within the context of recent models of self-monitoring deficits in these patients. Attentional dysfunctions and certain impairments of motor control and motor imagery all point towards the involvement of the parietal cortex in the disorder. In particular, we suggest that patients experiencing passivity phenomena (e.g., delusions of control) may have particular impairments of parietal function related to poor utilisation of forward models of intended actions. We also present a novel hypothesis that suggests differential impairments of the left and right parietal cortices in schizophrenia may help explain many of the first-rank symptoms of the disorder.
最近许多精神分裂症模型试图从思维和行为自我监测功能的崩溃角度来解释所谓的一级症状。这些模型聚焦于精神分裂症最常见的症状——幻听，认为幻听可能代表着对内心言语的自我监测紊乱。因此，颞叶和额叶皮质在精神分裂症患者临床表现中的作用受到了广泛关注。在本综述中，我们在近期关于这些患者自我监测缺陷模型的背景下，研究顶叶后皮质（PPC）在精神分裂症中的作用。注意力功能障碍以及运动控制和运动想象的某些损伤都表明顶叶皮质参与了该疾病。特别是，我们认为经历被动现象（如控制妄想）的患者可能在顶叶功能方面存在特定损伤，这与对预期动作前向模型的利用不足有关。我们还提出了一个新假设，即精神分裂症患者左右顶叶皮质的不同损伤可能有助于解释该疾病的许多一级症状。
