Bellgrove Mark A, Chambers Christopher D, Vance Alasdair, Hall Nicole, Karamitsios Mary, Bradshaw John L
Cognitive Neuroscience Laboratory, School of Behavioural Science, University of Melbourne, Parkville, Victoria, Australia.
Psychol Med. 2006 Apr;36(4):495-505. doi: 10.1017/S0033291705006409. Epub 2005 Dec 12.
The ability to inhibit inappropriate or unwanted actions is a key element of executive control. The existence of executive function deficits in schizophrenia is consistent with frontal lobe theories of the disorder. Relatively few studies have examined response inhibition in schizophrenia, and none in adolescent patients with early-onset schizophrenia (EOS).
Twenty-one adolescents with the onset of clinically impairing psychosis before 19 years of age and 16 matched controls performed a stop-signal task to assess response inhibition. The patients with EOS were categorized as paranoid (n = 10) and undifferentiated subtypes (n = 11). The undifferentiated group had higher levels of negative symptomatology. Stop-signal reaction time (SSRT) and go-signal reaction time (Go-RT) were analysed with respect to hand of response.
The undifferentiated early-onset patients had significantly longer SSRTs, indicative of poor response inhibition, for the left hand compared to the paranoid early-onset patients and control participants. No differences existed for inhibitory control with the right hand. The three groups did not differ in Go-RT.
Our results indicate a specific lateralized impairment of response inhibition in patients with undifferentiated, but not paranoid, EOS. These findings are consistent with reports of immature frontostriatal networks in EOS and implicate areas such as the pre-motor cortex and supplementary motor area (SMA) that are thought to play a role in both voluntary initiation and inhibition of movement.
抑制不适当或不必要行为的能力是执行控制的关键要素。精神分裂症存在执行功能缺陷与该疾病的额叶理论相符。相对较少的研究考察了精神分裂症患者的反应抑制能力,且尚无针对早发性精神分裂症(EOS)青少年患者的相关研究。
21名在19岁之前出现临床损害性精神病发作的青少年以及16名匹配的对照组完成一项停止信号任务以评估反应抑制能力。EOS患者被分为偏执型(n = 10)和未分化型(n = 11)。未分化组的阴性症状水平更高。针对反应手分析停止信号反应时间(SSRT)和启动信号反应时间(Go-RT)。
与偏执型早发性患者及对照组参与者相比,未分化型早发性患者左手的SSRT显著更长,表明反应抑制能力较差。右手的抑制控制方面不存在差异。三组在Go-RT上无差异。
我们的结果表明,未分化型而非偏执型EOS患者存在特定的反应抑制侧化损害。这些发现与EOS患者额纹状体网络不成熟的报道一致,并涉及到诸如运动前皮质和辅助运动区(SMA)等被认为在运动的自主发起和抑制中均起作用的区域。