Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 9, Ireland.
Schizophr Res. 2010 Oct;123(1):71-6. doi: 10.1016/j.schres.2010.05.028. Epub 2010 Jun 26.
Neuropsychological impairment is a core feature of schizophrenia. Adolescents reporting subclinical psychotic symptoms are considered to be at greater risk of developing a psychotic illness later in life than adolescents who do not report such symptoms and, thus, may represent an at-risk group for further study. We wished to investigate neuropsychological functioning in early adolescence in relation to reports of psychotic symptoms.
Participants were recruited from local primary schools after a two-stage screening and parental consent process. In brief, 277 adolescents were screened and 37 attended for testing. Seventeen adolescents who were deemed to report 'definite' psychotic symptoms after clinical interview and 20 control adolescents underwent a clinical interview and a one-hour neuropsychological battery.
Adolescents who report psychotic symptoms exhibited significant impairments in receptive language (as measured by the British Picture Vocabulary Scale), motor function (as measured by the Pegboard test) and executive function/speed of processing (as measured by the Trail-Making test). There were no significant differences between the groups on measures of attention, memory or expressive language, abstract reasoning or overall scholastic ability.
Taken together with the results from birth cohort, genetic high risk and prodromal studies, these findings are consistent with a neural inefficiency/disconnectivity hypothesis in those at risk for psychosis. These results highlight the need to investigate developmental brain circuits subserving language and motor function and processing speed and how these change over time in at-risk adolescents.
神经认知损伤是精神分裂症的核心特征。出现亚临床精神病症状的青少年比没有此类症状的青少年在以后的生活中更有可能发展为精神病,因此被认为是处于高危状态,需要进一步研究。我们希望研究青少年早期的神经认知功能与精神病症状报告之间的关系。
通过两阶段筛选和家长同意的过程,从当地小学招募参与者。简要地说,对 277 名青少年进行了筛查,有 37 名青少年参加了测试。经过临床访谈,17 名被认为报告“明确”精神病症状的青少年和 20 名对照青少年接受了临床访谈和一个小时的神经心理学测试。
报告精神病症状的青少年在接受性语言(通过英国图片词汇量表测量)、运动功能(通过钉板测试测量)和执行功能/处理速度(通过连线测试测量)方面表现出显著的损伤。两组在注意力、记忆或表达性语言、抽象推理或整体学业能力方面没有显著差异。
结合来自出生队列、遗传高风险和前驱期研究的结果,这些发现与精神病高危人群的神经效率/连接中断假说一致。这些结果强调需要研究语言和运动功能以及处理速度的发育中的大脑回路,以及这些回路在高危青少年中随时间的变化。