Department of Psychiatry, Wuxi Mental Health Center of Nanjing Medical University, Wuxi, Jiangsu Province, China.
PLoS One. 2013;8(1):e52186. doi: 10.1371/journal.pone.0052186. Epub 2013 Jan 7.
Cognitive deficits are considered core symptoms of the schizophrenia. Cognitive function has been found to be a better predictor of functional outcome than symptom levels. Changed mismatch negativity (MMN) reflects abnormalities of early auditory processing in schizophrenia. Up to now, no studies for the effects of aripiprazole on MMN in schizophrenia have been reported.
METHODOLOGY/PRINCIPAL FINDINGS: Subjects included 26 patients with schizophrenia, and 26 controls. Psychopathology was rated in patients with the Positive and Negative Syndrome Scale (PANSS) at baseline, after 4- and 8-week treatments with aripiprazole. Auditory stimuli for ERP consisted of 100 millisecond/1000 Hz standards, intermixed with 100 millisecond/1500 Hz frequency deviants and 250 millisecond/1000 Hz duration deviants. EEG was recorded at Fz. BESA 5.1.8 was used to perform data analysis. MMN waveforms were obtained by subtracting waveforms elicited by standards from waveforms elicited by frequency- or duration-deviant stimuli. Aripiprazole decreased all PANSS. Patients showed smaller mean amplitudes of frequency and duration MMN at baseline than did controls. A repeated measure ANOVA with sessions (i.e., baseline, 4- and 8-week treatments) and MMN type (frequency vs. duration) as within-subject factors revealed no significant MMN type or MMN type × session main effect for MMN amplitudes. Session main effect was significant. LSD tests demonstrated significant differences between MMN amplitudes at 8 weeks and those at both baseline and 4 weeks. There was significant negative correlation between changes in amplitudes of frequency and duration MMN and changes in PANSS total scores at baseline and follow-up periods.
Aripiprazole improved the amplitudes of MMN. MMN offers objective evidence that treatment with the aripiprazole may ameliorate preattentive deficits in schizophrenia.
认知缺陷被认为是精神分裂症的核心症状。研究发现,认知功能比症状水平更能预测功能结果。变化的失匹配负波(MMN)反映了精神分裂症早期听觉处理的异常。到目前为止,还没有报道过阿立哌唑对精神分裂症患者 MMN 的影响的研究。
方法/主要发现:研究对象包括 26 名精神分裂症患者和 26 名对照者。在基线、阿立哌唑治疗 4 周和 8 周后,使用阳性和阴性症状量表(PANSS)对患者的精神病学进行了评定。ERP 的听觉刺激由 100 毫秒/1000 Hz 标准、100 毫秒/1500 Hz 频率偏差和 250 毫秒/1000 Hz 持续时间偏差组成。脑电图记录在 Fz 上。使用 BESA 5.1.8 进行数据分析。通过从频率或持续时间偏差刺激诱发的波形中减去标准诱发的波形,获得 MMN 波形。使用重复测量方差分析,以阶段(即基线、4 周和 8 周治疗)和 MMN 类型(频率与持续时间)作为受试者内因素,发现 MMN 振幅没有显著的 MMN 类型或 MMN 类型×阶段主效应。阶段主效应显著。LSD 检验表明,8 周时的 MMN 振幅与基线和 4 周时的 MMN 振幅有显著差异。在基线和随访期间,频率和持续时间 MMN 振幅的变化与 PANSS 总分的变化呈显著负相关。
阿立哌唑改善了 MMN 的振幅。MMN 提供了客观证据,表明阿立哌唑的治疗可能改善精神分裂症的前注意缺陷。