Professor, Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh.
Indian J Psychiatry. 2006 Oct;48(4):215-22. doi: 10.4103/0019-5545.31552.
In recent years, the development of positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging has enhanced our understanding of the physiological functioning of the intact brain.
To study cerebral cortical perfusion defects in patients with childhood onset schizophrenia (COS) and to assess their neuropsychological functioning.
This cross-sectional study comprised 14 patients with COS with onset at or before 14 years of age, diagnosed as per ICD-10 DCR criteria, attending a tertiary care centre in North India. All the patients were assessed on sociodemographic, clinical profile sheet, Positive and Negative Symptom Scale (PANSS) and Edinburgh Handedness Inventory (EHI). The Wisconsin Card Sorting Test (WCST) was used to assess their neuropsychological functioning. All patients underwent SPECT. A control group of 10 healthy subjects was studied with SPECT for comparison.
Nine patients (64.3%) showed perfusion anomaly on SPECT scan specifically in the left temporal and frontal areas of the brain. On WCST score these 9 patients showed a higher percentage of total errors (64.49%+/-9.42%) as compared to the other 5 patients (48.54%+/-12.70%) who showed no abnormality on SPECT scan. All normal control subjects showed no abnormality on SPECT.
The results from WCST show that COS patients have difficulty in executive functioning. Also, patients had perfusion anomaly in the left temporal, frontal and parietal areas. Deficits found in COS are similar to those found in adult onset schizophrenia (AOS). In view of the findings, the nature of COS and its relationship with AOS are discussed.
近年来，正电子发射断层扫描（PET）和单光子发射计算机断层扫描（SPECT）成像的发展增强了我们对完整大脑生理功能的理解。
研究儿童期发病精神分裂症（COS）患者的大脑皮质灌注缺陷，并评估其神经心理学功能。
本横断面研究纳入了 14 名发病年龄在 14 岁或 14 岁之前的儿童期发病精神分裂症患者，符合 ICD-10 DCR 标准，来自印度北部的一家三级护理中心。所有患者均接受了社会人口统计学、临床特征表、阳性和阴性症状量表（PANSS）和爱丁堡手性量表（EHI）评估。威斯康星卡片分类测试（WCST）用于评估他们的神经心理学功能。所有患者均接受 SPECT 检查。对 10 名健康对照者进行了 SPECT 检查，以进行比较。
9 名患者（64.3%）的 SPECT 扫描显示特定于大脑左颞区和额叶区的灌注异常。在 WCST 评分中，这 9 名患者的总错误率（64.49%+/-9.42%）明显高于其他 5 名未在 SPECT 扫描中显示异常的患者（48.54%+/-12.70%）。所有正常对照组均未在 SPECT 扫描中显示异常。
WCST 的结果表明，COS 患者在执行功能方面存在困难。此外，患者在左颞、额和顶叶区域出现灌注异常。在 COS 中发现的缺陷与在成年发病精神分裂症（AOS）中发现的缺陷相似。鉴于这些发现，讨论了 COS 的性质及其与 AOS 的关系。
