Ungvari Gabor S, Xiang Yu-Tao, Tang Wai-Kwong, Shum David
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China.
Arch Clin Neuropsychol. 2008 Sep;23(5):613-22. doi: 10.1016/j.acn.2008.06.005. Epub 2008 Jul 17.
Prospective memory (PM) is the ability to remember to do something in the future without explicit prompts. Extending the number of subjects and the scope of our previously published study, this investigation examined the relationship between PM and socio-demographic and clinical factors, activities of daily living (ADL) and frontal lobe functions in patients with chronic schizophrenia.
One hundred and ten Chinese schizophrenia patients, 60 from the previous study and 50 additional patients recruited for this study, and 110 matched healthy comparison subjects (HC) formed the study sample. Patients' clinical condition and activity of daily living were evaluated with the Brief Psychiatric Rating Scale (BPRS) and the Functional Needs Assessment (FNA). Time- and event-based PM tasks and three tests of prefrontal lobe functions (Design Fluency Test [DFT], Tower of London [TOL], Wisconsin Card Sorting Test [WCST]) were also administered.
Patients' level of ADL and psychopathology were not associated with PM functions and only anticholinergic medications (ACM) showed a significant negative correlational relationship with PM tasks. Confirming the findings of the previous study, patients performed significantly more poorly on all two PM tasks than HC. Performance on time-based PM task significantly correlated with age, education level and DFT in HC and with age, DFT, TOL and WCST in patients. Patients' performance on the event-based PM correlated with DFT and one measure of WCST. In patients, TOL and age predicted the performance on time-based PM task; DFT and WCST predicted the event-based task.
Involving a large sample of patients with matched controls, this study confirmed that PM is impaired in chronic schizophrenia. Deficient PM functions were related to prefrontal lobe dysfunction in both HC and patients but not to the patients' clinical condition, nor did they significantly affect ADL. ACMs determined certain aspects of PM.
前瞻性记忆（PM）是指在没有明确提示的情况下记住将来要做某事的能力。本研究扩大了先前发表研究的样本数量和范围，探讨了慢性精神分裂症患者的前瞻性记忆与社会人口统计学和临床因素、日常生活活动（ADL）以及额叶功能之间的关系。
110名中国精神分裂症患者（其中60名来自先前的研究，另外50名是为本研究新招募的）和110名匹配的健康对照者（HC）组成了研究样本。使用简明精神病评定量表（BPRS）和功能需求评估（FNA）对患者的临床状况和日常生活活动进行评估。还进行了基于时间和事件的前瞻性记忆任务以及三项额叶功能测试（设计流畅性测试[DFT]、伦敦塔测试[TOL]、威斯康星卡片分类测试[WCST]）。
患者的ADL水平和精神病理学与前瞻性记忆功能无关，仅抗胆碱能药物（ACM）与前瞻性记忆任务呈显著负相关。与先前研究结果一致，患者在两项前瞻性记忆任务上的表现均显著差于健康对照者。在健康对照者中，基于时间的前瞻性记忆任务表现与年龄、教育水平和DFT显著相关；在患者中，与年龄、DFT、TOL和WCST显著相关。患者在基于事件的前瞻性记忆任务上的表现与DFT和WCST的一项指标相关。在患者中，TOL和年龄可预测基于时间的前瞻性记忆任务表现；DFT和WCST可预测基于事件的任务表现。
本研究纳入了大量患者及匹配的对照组，证实慢性精神分裂症患者的前瞻性记忆受损。前瞻性记忆功能缺陷在健康对照者和患者中均与额叶功能障碍有关，但与患者的临床状况无关，也未对ADL产生显著影响。抗胆碱能药物决定了前瞻性记忆的某些方面。
