Eren Ibrahim, Civi Ikbal, Yildiz Mustafa
Psikiyatri AD., Süleyman Demirel U Tip Fak., Isparta.
Turk Psikiyatri Derg. 2005 Winter;16(4):284-90.
Capgras syndrome (CS) is characterized by the delusional belief that a person, usually very close to the patient, has been replaced by a double who is physically very similar to the original. CS is relatively rare, occurring predominantly in course of schizophrenia, particularly of the paranoid sub-type, and less frequently in association with schizoaffective and affective disorder. Recent years have witnessed a sharp increase in the number of published CS cases with an organic etiology; however, CS was considered to have its origins in psychodynamic conflict. We present a patient with the CS and brain SPECT findings whom without psychiatric disorder. As an evaluation of brain SPECT, there have been found a significantly decreased blood flow in bilateral parietal regions and slightly decreased blood flow in bilateral posterior frontal regions. Cerebral dysfunction is proposed to be a central role in CS development. Unilateral right hemisphere lesions occur more frequently than the left; however, the majority of CS cases show bilateral involvement. Pathology involves many parts of the brain, most notably frontal and parietal cortex. Our findings support that frontoparietal dysfunction could be important in the pathogenesis of CS. We reviewed the neurobiology of CS and discussed our findings in this article. CS studies will give a better understanding of the neurobiological basis of psychotic experiences and may contribute to develop a paradigm on researches about other psychotic disorders.
卡普格拉综合征(CS)的特征是存在一种妄想信念,即认为一个人(通常是与患者关系非常亲密的人)被一个外貌与原人极为相似的替身所取代。CS相对罕见,主要发生在精神分裂症病程中,尤其是偏执型亚型,较少与精神分裂情感障碍和情感障碍相关联。近年来,有器质性病因的已发表CS病例数量急剧增加;然而,CS曾被认为起源于心理动力学冲突。我们报告一例患有CS且有脑单光子发射计算机断层扫描(SPECT)结果的患者,其无精神障碍。作为对脑SPECT的评估,发现双侧顶叶区域血流显著减少,双侧额叶后部区域血流略有减少。脑功能障碍被认为在CS的发生发展中起核心作用。右侧半球单侧病变比左侧更常见;然而,大多数CS病例显示双侧受累。病理涉及脑的许多部位,最显著的是额叶和顶叶皮质。我们的研究结果支持额顶叶功能障碍在CS发病机制中可能很重要。我们在本文中回顾了CS的神经生物学并讨论了我们的研究结果。CS研究将有助于更好地理解精神病体验的神经生物学基础,并可能有助于建立关于其他精神障碍研究的范例。