Lee Junghee, Green Michael F, Calkins Monica E, Greenwood Tiffany A, Gur Raquel E, Gur Ruben C, Lazzeroni Laura C, Light Gregory A, Nuechterlein Keith H, Radant Allen D, Seidman Larry J, Siever Larry J, Silverman Jeremy M, Sprock Joyce, Stone William S, Sugar Catherine A, Swerdlow Neal R, Tsuang Debby W, Tsuang Ming T, Turetsky Bruce I, Braff David L
Department of Psychiatry and Biobehavioral Science, Geffen School of Medicine, University of California Los Angeles, CA, United States; VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States.
Department of Psychiatry and Biobehavioral Science, Geffen School of Medicine, University of California Los Angeles, CA, United States; VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States.
Schizophr Res. 2015 Apr;163(1-3):24-31. doi: 10.1016/j.schres.2014.08.014. Epub 2014 Sep 22.
Working memory impairment has been extensively studied in schizophrenia, but less is known about moderators of the impairment. Using the Consortium on the Genetics of Schizophrenia case-control study (COGS-2), we examined smoking status, types of antipsychotic medication, and history of substance as moderators for working memory impairment in schizophrenia.
From 5 sites, 1377 patients with schizophrenia or schizoaffective, depressed type and 1037 healthy controls completed the letter-number span (LNS) task. The LNS uses intermixed letter and digit stimuli that increase from 2 up to 8 stimuli. In the forward condition, participants repeated the letters and numbers in the order they were presented. In the reorder condition, participants repeated the digits in ascending order followed by letters in alphabetical order.
Schizophrenia patients performed more poorly than controls, with a larger difference on reorder than forward conditions. Deficits were associated with symptoms, functional capacity, and functional outcome. Patients who smoked showed larger impairment than nonsmoking patients, primarily due to deficits on the reorder condition. The impairing association of smoking was more pronounced among patients taking first-generation than those taking second-generation antipsychotic medications. Correlations between working memory and community functioning were stronger for nonsmokers. History of substance use did not moderate working memory impairment.
Results confirm the working memory impairment in schizophrenia, and indicate smoking status as an important moderator for these deficits. The greater impairment in smokers may reflect added burden of smoking on general health or that patients with greater deficits are more likely to smoke.
工作记忆损害在精神分裂症中已得到广泛研究，但对该损害的调节因素了解较少。利用精神分裂症遗传学联盟病例对照研究（COGS - 2），我们研究了吸烟状况、抗精神病药物类型和物质使用史作为精神分裂症工作记忆损害的调节因素。
来自5个地点的1377例精神分裂症或分裂情感性抑郁型患者及1037名健康对照完成了字母数字广度（LNS）任务。LNS使用从2到8个刺激递增的字母和数字混合刺激。在前瞻条件下，参与者按呈现顺序重复字母和数字。在重新排序条件下，参与者先按升序重复数字，然后按字母顺序重复字母。
精神分裂症患者的表现比对照组差，在重新排序条件下的差异比前瞻条件下更大。缺陷与症状、功能能力和功能结局相关。吸烟患者比不吸烟患者表现出更大的损害，主要是由于在重新排序条件下的缺陷。吸烟的损害关联在服用第一代抗精神病药物的患者中比服用第二代抗精神病药物的患者中更明显。非吸烟者的工作记忆与社区功能之间的相关性更强。物质使用史并未调节工作记忆损害。
结果证实了精神分裂症患者存在工作记忆损害，并表明吸烟状况是这些缺陷的重要调节因素。吸烟者中更大的损害可能反映了吸烟对总体健康的额外负担，或者缺陷更大的患者更可能吸烟。
