Braff D L, Grillon C, Geyer M A
Department of Psychiatry, University of California, San Diego, La Jolla 92093-0804.
Arch Gen Psychiatry. 1992 Mar;49(3):206-15. doi: 10.1001/archpsyc.1992.01820030038005.
Schizophrenic patients exhibit impairments in both sensorimotor gating and habituation in a number of paradigms. Through human and animal model research, these fundamental cognitive deficits have well-described neurobiologic bases and offer insights into the neuroanatomic and neurotransmitter abnormalities that characterize patients with schizophrenic spectrum disorders. In this context, the startle response is particularly interesting, because it is a cross-species response to strong stimuli that is plastic or alterable using experimental and neurobiologic manipulations. Thirty-nine medicated schizophrenic patients and 37 normal control subjects were studied in a new electromyography based startle response paradigm in which both prepulse inhibition (an operational measure of sensorimotor gating) and habituation (the normal decrease in response magnitude to repeated stimuli over time) can be separated and assessed in one test session. The results indicate that schizophrenic patients have extensive deficits in both intramodal and cross-modal sensorimotor gating and a trend to show acoustic startle habituation deficits. The deficit in prepulse inhibition of startle amplitude exhibited by schizophrenic patients was evident when an acoustic prepulse stimulus preceded either an acoustic or a tactile startle stimulus. No deficit was observed in the prepulse-induced facilitation of startle latencies, indicating that the failure of gating was not due to a failure of stimulus detection. These findings suggest centrally mediated deficits in sensorimotor gating in schizophrenic patients.
精神分裂症患者在多种范式下的感觉运动门控和习惯化方面均表现出损伤。通过人类和动物模型研究,这些基本的认知缺陷具有详尽描述的神经生物学基础,并为精神分裂症谱系障碍患者所特有的神经解剖学和神经递质异常提供了见解。在此背景下,惊跳反应尤其有趣,因为它是对强刺激的一种跨物种反应,可通过实验和神经生物学操作进行塑造或改变。在一种基于肌电图的新型惊跳反应范式中,对39名接受药物治疗的精神分裂症患者和37名正常对照受试者进行了研究,在该范式中,前脉冲抑制(感觉运动门控的一种操作性测量)和习惯化(随着时间推移对重复刺激的反应幅度正常降低)均可在一次测试环节中分离并进行评估。结果表明,精神分裂症患者在模态内和跨模态感觉运动门控方面均存在广泛缺陷,并且有出现听觉惊跳习惯化缺陷的趋势。当听觉前脉冲刺激先于听觉或触觉惊跳刺激出现时,精神分裂症患者在前脉冲抑制惊跳幅度方面的缺陷很明显。在前脉冲诱导的惊跳潜伏期促进方面未观察到缺陷,这表明门控失败并非由于刺激检测失败所致。这些发现提示精神分裂症患者存在感觉运动门控的中枢介导缺陷。