Wexler B E, Giller E L, Southwick S
Connecticut Mental Health Center, New Haven 06519.
Biol Psychiatry. 1991 Jan 15;29(2):103-16. doi: 10.1016/0006-3223(91)90039-o.
A dichotic nonsense test and a dichotic word test were used to assess cerebral laterality in 100 acutely symptomatic inpatients. Schizophrenic patients had significantly lower right ear advantages (REAs) than healthy controls, depressed patients, or schizoaffective patients. Manic patients did not differ from any other group, but manics with lower REAs were likely to have more symptoms of thought disorder than of mood disturbance while the reverse was likely to be true for manic patients with higher REAs. A subset of patients tested after symptom remission showed recovery-related increases in REA on the nonsense test and decreases on the word test, replicating previous findings. Those schizophrenics with evidence of greater disease-related decreases in REA on the nonsense than on the word test had predominantly negative symptoms whereas those with similar changes on the two tests had predominantly positive symptoms. These observations suggest the hypothesis that positive symptoms are related to overactivation of a dysfunctional left hemisphere by right hemisphere input while negative symptoms reflect a left hemisphere deficit state.
采用双耳分听无意义音节测验和双耳分听单词测验对100名急性症状住院患者的大脑偏侧性进行评估。精神分裂症患者的右耳优势（REA）显著低于健康对照者、抑郁症患者或精神分裂情感障碍患者。躁狂症患者与其他任何组均无差异，但右耳优势较低的躁狂症患者思维障碍症状可能多于情绪障碍症状，而右耳优势较高的躁狂症患者情况可能相反。症状缓解后接受测试的部分患者在无意义音节测验中显示出与恢复相关的右耳优势增加，而在单词测验中则降低，重复了先前的研究结果。那些在无意义音节测验中右耳优势较单词测验有更大与疾病相关下降的精神分裂症患者主要表现为阴性症状，而在两项测验中有类似变化的患者主要表现为阳性症状。这些观察结果提示了这样一种假说，即阳性症状与功能失调的左半球因右半球输入而过度激活有关，而阴性症状反映了左半球的缺陷状态。
