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不同精神病风险状态下的神经心理学特征:前驱期早期的执行控制损伤——以及前驱期晚期的额外记忆功能障碍。

Neuropsychological profiles in different at-risk states of psychosis: executive control impairment in the early--and additional memory dysfunction in the late--prodromal state.

机构信息

Department of Psychiatry, University Hospital of Bonn, Sigmund-Freud-Street 25, Bonn, Germany.

出版信息

Schizophr Bull. 2011 Jul;37(4):861-73. doi: 10.1093/schbul/sbp155. Epub 2010 Jan 6.


DOI:10.1093/schbul/sbp155
PMID:20053865
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3122293/
Abstract

Impairments in neuropsychological functioning have been described in subjects clinically at high risk for psychosis, but the specific cognitive deficits in different clinical high-risk groups remain to be elucidated. The German Research Network on Schizophrenia employs a heuristic 2-stage model: a putatively late prodromal state (LPS), characterized by the onset of attenuated positive or brief psychotic symptoms, and an early prodromal state (EPS), mainly characterized by the presence of basic symptoms, which are predictive for psychosis within the next 10 years. A total of 205 subjects met the criteria for either an EPS or an LPS of psychosis and were assessed with a comprehensive neuropsychological test battery. Neurocognitive profiles of high-risk groups were compared with data of 87 healthy controls comparable with regard to gender, age, and premorbid verbal IQ. Patients in the LPS were impaired in all neurocognitive domains (memory/learning, executive control/processing speed, and working memory) examined, with memory being the worst. Deficits were less pronounced in patients in the EPS, with a specific deficit in the executive control/processing speed domain. Consistent with a progressive neurodevelopmental disorder, some cognitive abilities were already impaired in patients in the EPS, followed by further deterioration in the LPS. Specifically, deficits in executive control functioning were related to the presence of basic symptoms, indicating a vulnerability for psychosis. Memory deficits were associated with the onset of psychotic symptoms indicating further disease progression in the trajectory to psychosis and, thus, may be useful in predicting psychosis and targeting early intervention.

摘要

神经心理功能障碍在临床上处于精神病高风险的受试者中已有描述,但不同临床高风险组的具体认知缺陷仍有待阐明。德国精神分裂症研究网络采用启发式 2 阶段模型:一个假定的迟发性前驱状态(LPS),其特征是出现轻度阳性或短暂精神病症状,以及一个早期前驱状态(EPS),主要特征是存在基本症状,这在前 10 年内预测精神病。共有 205 名受试者符合精神病的 EPS 或 LPS 标准,并接受了全面的神经心理学测试。高危人群的神经认知特征与 87 名健康对照组的数据进行了比较,这些对照组在性别、年龄和前病语言智商方面具有可比性。处于 LPS 的患者在所有神经认知领域(记忆/学习、执行控制/处理速度和工作记忆)均受到损害,其中记忆最差。处于 EPS 的患者的缺陷不那么明显,在执行控制/处理速度领域存在特定的缺陷。与进行性神经发育障碍一致,一些认知能力在处于 EPS 的患者中已经受损,随后在 LPS 中进一步恶化。具体而言,执行控制功能的缺陷与基本症状的存在有关,表明存在精神病易感性。记忆缺陷与精神病症状的出现有关,表明精神病轨迹的疾病进一步进展,因此可能有助于预测精神病并进行早期干预。

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[3]
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[4]
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Eur Child Adolesc Psychiatry. 2024-1

[5]
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[6]
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[7]
Dissociable impairments of verbal learning differentiate childhood risk profiles for schizophrenia.

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[8]
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Eur Arch Psychiatry Clin Neurosci. 2022-4

[9]
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Schizophr Res Cogn. 2021-7-28

[10]
Generalized neurocognitive impairment in individuals at ultra-high risk for psychosis: The possible key role of slowed processing speed.

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本文引用的文献

[1]
When does cognitive decline occur in the period prior to the first episode of schizophrenia?

Psychiatry (Edgmont). 2009-7

[2]
Neuroanatomical correlates of different vulnerability states for psychosis and their clinical outcomes.

Br J Psychiatry. 2009-9

[3]
Use of neuroanatomical pattern classification to identify subjects in at-risk mental states of psychosis and predict disease transition.

Arch Gen Psychiatry. 2009-7

[4]
Neurocognition in first-episode schizophrenia: a meta-analytic review.

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Progressive brain structural changes mapped as psychosis develops in 'at risk' individuals.

Schizophr Res. 2009-3

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Biol Psychiatry. 2008-11-1

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Psychol Med. 2009-3

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Impaired sensorimotor gating of the acoustic startle response in the prodrome of schizophrenia.

Biol Psychiatry. 2008-11-1

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Interrelated neuropsychological and anatomical evidence of hippocampal pathology in the at-risk mental state.

Psychol Med. 2008-6

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