Chen K C, Lee I H, Yang Y K, Landau S, Chang W H, Chen P S, Lu R B, David A S, Bramon E
Department of Psychiatry,National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan.
Department of Biostatistics, Institute of Psychiatry,King's College London,UK.
Psychol Med. 2014 Jul;44(10):2151-62. doi: 10.1017/S0033291713002808. Epub 2013 Nov 15.
Reduced P300 event-related potential (ERP) amplitude and latency prolongation have been reported in patients with schizophrenia compared to healthy controls. However, the influence of antipsychotics (and dopamine) on ERP measures are poorly understood and medication confounding remains a possibility.
We explored ERP differences between 36 drug-naive patients with schizophrenia and 138 healthy controls and examined whether P300 performance was related to dopamine transporter (DAT) availability, both without the confounding effects of medication. We also conducted a random effects meta-analysis of the available literature, synthesizing the results of three comparable published articles and our local study.
No overall significant difference was found in mean P300 ERP between patients and controls in latency or in amplitude. There was a significant gender effect, with females showing greater P300 amplitude than males. A difference between patients and controls in P300 latency was evident with ageing, with latency increasing faster in patients. No effect of DAT availability on P300 latency or amplitude was detected. The meta-analysis computed the latency pooled standardized effect size (PSES; Cohen's d) of -0.13 and the amplitude PSES (Cohen's d) of 0.48, with patients showing a significant reduction in amplitude.
Our findings suggest the P300 ERP is not altered in the early stages of schizophrenia before medication is introduced, and the DAT availability does not influence the P300 ERP amplitude or latency. P300 ERP amplitude reduction could be an indicator of the progression of illness and chronicity.
与健康对照相比，精神分裂症患者的P300事件相关电位（ERP）波幅降低和潜伏期延长已有报道。然而，抗精神病药物（及多巴胺）对ERP测量指标的影响尚不清楚，药物干扰仍是一种可能。
我们探究了36例未用药的精神分裂症患者与138例健康对照之间的ERP差异，并在无药物干扰的情况下，研究P300表现是否与多巴胺转运体（DAT）可用性有关。我们还对现有文献进行了随机效应荟萃分析，综合了三篇可比已发表文章及我们本地研究的结果。
患者与对照之间在P300 ERP的平均潜伏期或波幅上未发现总体显著差异。存在显著的性别效应，女性的P300波幅高于男性。随着年龄增长，患者与对照在P300潜伏期上的差异明显，患者的潜伏期增加得更快。未检测到DAT可用性对P300潜伏期或波幅有影响。荟萃分析计算出潜伏期合并标准化效应量（PSES；科恩d值）为-0.13，波幅PSES（科恩d值）为0.48，患者的波幅显著降低。
我们的研究结果表明，在未用药的精神分裂症早期阶段，P300 ERP未发生改变，且DAT可用性不影响P300 ERP的波幅或潜伏期。P300 ERP波幅降低可能是疾病进展和慢性化的一个指标。
