Zhao Jingping, He Xiaolin, Liu Zhening, Yang Desen
Department of Psychiatry, Second Xiangya Hospital, Central South University, Hunan, China.
Int J Psychiatry Med. 2006;36(2):171-81. doi: 10.2190/1AA0-UW9Q-1CNK-3E2N.
Cognitive function and regional cerebral blood flow (rCBF) were studied in negative symptom profile schizophrenic patients by using WCST and SPECT.
Twenty-one schizophrenic patients who matched the criteria of Andreason's negative symptom profile received SPECT and WCST, and then were treated with clozapine for 8 consecutive weeks. There were 28 and 12 normal subjects as the control groups of WCST and SPECT, respectively.
Compared with controls, significantly poorer performance on total trials of category (TT), persevering errors (PE), and non-persevering errors (NPE) of WCST were found in schizophrenia (p < 0.05). The total score of the scale for assessment negative symptoms (SANS) was significantly related with poor TT (r = 0.45, p < 0.01) and PE performance (r = 0.45, p < 0.01). The poor TT, PE, and NPE tasks of WCST and SANS scores in the negative schizophrenic patients were significantly improved through clozapine treatment (p < 0.05). The schizophrenic patients had a significantly lower rCBF in bilateral frontal and temporal lobes and lower change rate of rCBF in bilateral frontal lobes during WCST compared to normal controls (p < 0.05).
Negative symptom profile schizophrenia has cognitive deficits and lower rCBF in bilateral frontal and temporal lobes, which suggests that negative symptom profile schizophrenic patients have hypofrontality. Clozapine can improve negative symptoms and improve cognitive dysfunction, although it cannot improve reduced rCBF in the frontal lobes.
运用威斯康星卡片分类测验（WCST）和单光子发射计算机断层扫描（SPECT）对阴性症状型精神分裂症患者的认知功能和局部脑血流量（rCBF）进行研究。
21例符合安德烈亚森阴性症状型标准的精神分裂症患者接受了SPECT和WCST检查，随后连续8周服用氯氮平。分别有28名和12名正常受试者作为WCST和SPECT的对照组。
与对照组相比，精神分裂症患者在WCST的分类总试验（TT）、持续性错误（PE）和非持续性错误（NPE）方面表现明显更差（p<0.05）。阴性症状评定量表（SANS）总分与TT差（r = 0.45，p<0.01）和PE表现（r = 0.45，p<0.01）显著相关。阴性精神分裂症患者WCST的TT、PE和NPE任务差以及SANS评分通过氯氮平治疗得到显著改善（p<0.05）。与正常对照组相比，精神分裂症患者在WCST期间双侧额叶和颞叶的rCBF显著降低，双侧额叶的rCBF变化率更低（p<0.05）。
阴性症状型精神分裂症存在认知缺陷，双侧额叶和颞叶的rCBF降低，这表明阴性症状型精神分裂症患者存在前额叶功能低下。氯氮平可以改善阴性症状并改善认知功能障碍，尽管它不能改善额叶rCBF的降低。
