Kumari Veena, Aasen Ingrid, Taylor Pamela, Ffytche Dominic H, Das Mrigen, Barkataki Ian, Goswami Sangeeta, O'Connell Paul, Howlett Michael, Williams Steven C R, Sharma Tonmoy
Department of Psychology, Institute of Psychiatry, King's College London, London, UK.
Schizophr Res. 2006 May;84(1):144-64. doi: 10.1016/j.schres.2006.02.017. Epub 2006 Apr 17.
Contemporary theories and evidence implicate frontal lobe dysfunction in violent behaviour as well as in schizophrenia. We applied functional magnetic resonance imaging (fMRI) to investigate and compare brain activation during an 'n-back' working memory task in groups of men with (i) schizophrenia and a history of serious physical violence (VS; n=13), (ii) schizophrenia without a history of violence (NVS: n=12), (iii) antisocial personality disorder (APD) and a history of serious physical violence (n=10), and (iv) no history of violence or a mental disorder (n=13). We observed comparable performance in all four groups during the control (0-back) condition. Subtle working memory deficits were seen in the NVS and APD groups but severe deficits emerged in the VS group relative to the healthy group. The VS group showed activation deficit bilaterally in the frontal lobe and precuneus when compared to the healthy group, and in the right inferior parietal region when compared to the NVS group during the working memory load condition. Frontal (bilateral) as well as right inferior parietal activity was negatively associated with the ratings of violence across all schizophrenia patients, with the right parietal region showing this association most strongly. APD patients, relative to healthy subjects, showed activation deficit in the left frontal gyrus, anterior cingulate and precuneus. It is concluded that reduced functional response in the frontal and inferior parietal regions leads to serious violence in schizophrenia perhaps via impaired executive functioning.
当代理论和证据表明，额叶功能障碍与暴力行为以及精神分裂症有关。我们应用功能磁共振成像（fMRI）来研究和比较四组男性在“n-back”工作记忆任务期间的大脑激活情况，这四组分别为：（i）患有精神分裂症且有严重身体暴力史的男性（VS组；n = 13），（ii）无暴力史的精神分裂症患者（NVS组：n = 12），（iii）反社会人格障碍（APD）且有严重身体暴力史的男性（n = 10），以及（iv）无暴力史或精神障碍的男性（n = 13）。我们观察到在对照（0-back）条件下，所有四组的表现相当。在NVS组和APD组中发现了轻微的工作记忆缺陷，但与健康组相比，VS组出现了严重的缺陷。在工作记忆负荷条件下，与健康组相比，VS组在额叶和楔前叶双侧表现出激活不足，与NVS组相比，在右侧顶下区域表现出激活不足。在所有精神分裂症患者中，额叶（双侧）以及右侧顶下区域的活动与暴力评分呈负相关，其中右侧顶叶区域的这种相关性最为强烈。与健康受试者相比，APD患者在左侧额回、前扣带回和楔前叶表现出激活不足。研究得出结论，额叶和顶下区域功能反应降低可能通过执行功能受损导致精神分裂症患者出现严重暴力行为。
