Chen Yue, Levy Deborah L, Sheremata Summer, Holzman Philip S
Department of Psychiatry, Harvard Medical School/McLean Hospital, Belmont, MA 02478, USA.
Schizophr Res. 2006 Dec;88(1-3):208-16. doi: 10.1016/j.schres.2006.06.004. Epub 2006 Jul 17.
Since Kraepelin's early distinction between bipolar disorder and schizophrenia, it has been assumed that these disorders represent two different pathophysiological processes, although they share many clinical symptoms. Previous studies showed that velocity discrimination, a sensitive psychophysiological measure of the visual motion system, is deficient in schizophrenia. Here we examined whether the motion processing impairment found in schizophrenia also occurs in bipolar disorder.
We compared 16 bipolar patients, 25 schizophrenic patients, and 25 normal controls on a velocity discrimination task. We measured the psychophysical threshold for velocity discrimination and contrast detection (as a control task) in all subjects.
Bipolar patients showed normal velocity discrimination thresholds at intermediate velocities, the range in which velocity cues dominate velocity discrimination, and at low velocities. Schizophrenic patients, however, showed elevated velocity discrimination thresholds at intermediate and low velocities. At higher velocities, both bipolar and schizophrenic patients showed elevated thresholds. All subjects showed normal contrast detection thresholds.
Normal velocity discrimination in the intermediate range of velocity indicates unimpaired motion processing in bipolar disorder. The abnormal velocity discrimination of both schizophrenic and bipolar patients at higher velocities may reflect impaired temporal processing rather than impaired motion processing per se. These results suggest that the pathophysiological processes of bipolar disorder and schizophrenia diverge at the stage of visual motion processing, a sensory component mediated primarily in the extrastriate cortex.
自从克雷佩林早期对双相情感障碍和精神分裂症做出区分以来,尽管这两种疾病有许多共同的临床症状,但人们一直认为它们代表两种不同的病理生理过程。先前的研究表明,速度辨别是视觉运动系统的一种敏感的心理生理测量指标,在精神分裂症患者中存在缺陷。在此,我们研究了精神分裂症中发现的运动处理障碍是否也存在于双相情感障碍中。
我们让16名双相情感障碍患者、25名精神分裂症患者和25名正常对照者完成一项速度辨别任务。我们测量了所有受试者的速度辨别心理物理阈值和对比度检测(作为对照任务)。
双相情感障碍患者在中等速度(速度线索主导速度辨别的范围)和低速时显示出正常的速度辨别阈值。然而,精神分裂症患者在中等速度和低速时速度辨别阈值升高。在较高速度时,双相情感障碍患者和精神分裂症患者的阈值均升高。所有受试者的对比度检测阈值均正常。
在中等速度范围内正常的速度辨别表明双相情感障碍患者的运动处理未受损。精神分裂症患者和双相情感障碍患者在较高速度时异常的速度辨别可能反映了时间处理受损,而非运动处理本身受损。这些结果表明,双相情感障碍和精神分裂症的病理生理过程在视觉运动处理阶段出现分歧,视觉运动处理是主要在纹外皮层介导的一种感觉成分。