Watanabe Yoshinori, Urakami Takahiro, Hongo Seiji, Ohtsubo Tenpei
Nanko Clinic of Psychiatry, Fukushima, Japan; Himorogi Psychiatric Institute, Tokyo, Japan.
Hum Psychopharmacol. 2015 Jan;30(1):28-41. doi: 10.1002/hup.2448. Epub 2014 Nov 19.
The study evaluated relationships between frontal lobe function in patients with schizophrenia and both their social adjustment and medication, using 22-channel near-infrared spectroscopy (NIRS).
One hundred ninety-nine stable patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision schizophrenia, whose medication had not been changed within the preceding 3 months and who were able to visit our clinics for NIRS, were the study subjects. As a comparator, 144 healthy volunteers who underwent a physical examination and the Mini-International Neuropsychiatric Interview also received NIRS.
The main outcomes evaluated were frontal lobe oxyhemoglobin concentration (OxHb) measured by NIRS, current medication, social adjustment, and scores on the Brief Psychiatric Rating Scale. The OxHb in schizophrenic patients (0.878 ± 1.1801 mM mm; n = 199) was significantly lower than that in the healthy volunteers (2.085 ± 1.7480 mM mm: n = 100) (p < 0.001). NIRS-measured OxHb values reflected disease severity and degree of social adjustment in schizophrenic patients.
Patients with higher OxHb values were socially better adjusted than those with lower OxHb values. Patients treated with atypical antipsychotic monotherapy showed lower treatment resistance and better social adjustment than those treated with combination therapy.
本研究使用22通道近红外光谱技术(NIRS)评估精神分裂症患者的额叶功能与其社会适应能力及药物治疗之间的关系。
研究对象为199例病情稳定的《精神疾病诊断与统计手册》第四版,修订版(DSM-IV-TR)精神分裂症患者,这些患者在过去3个月内未改变用药,且能够前来我们的诊所接受NIRS检查。作为对照,144名接受了体格检查和迷你国际神经精神访谈的健康志愿者也接受了NIRS检查。
评估的主要结果包括通过NIRS测量的额叶氧合血红蛋白浓度(OxHb)、当前用药情况、社会适应能力以及简明精神病评定量表得分。精神分裂症患者的OxHb(0.878±1.1801 mM·mm;n = 199)显著低于健康志愿者(2.085±1.7480 mM·mm;n = 100)(p < 0.001)。NIRS测量的OxHb值反映了精神分裂症患者的疾病严重程度和社会适应程度。
OxHb值较高的患者比OxHb值较低的患者社会适应能力更好。接受非典型抗精神病药物单一疗法治疗的患者比接受联合疗法治疗的患者治疗抵抗性更低,社会适应能力更好。