Schulz Steffen, Haueisen Jens, Bär Karl-Jürgen, Andreas Voss
Department of Medical Engineering and Biotechnology, Ernst-Abbe-Hochschule Jena, University of Applied Sciences, Jena, Germany.
Institute of Biomedical Engineering and Informatics, Ilmenau University of Technology, Ilmenau, Germany.
Philos Trans A Math Phys Eng Sci. 2015 Feb 13;373(2034). doi: 10.1098/rsta.2014.0098.
Schizophrenia as a mental illness is one of the most serious in the world. Patients with schizophrenia have an increased cardiac mortality rate, but the reasons for this remain unclear. In addition to other factors, the role of impaired autonomic regulation during acute psychosis has become more evident in different studies applying heart rate (HR) variability analyses. But, until now, respiration and cardiorespiratory regulation, which are important for homeostatic control, have not been considered. In this study, short-term cardiorespiratory couplings (CRCs) of 23 unmedicated patients with paranoid schizophrenia (SZO), 20 of their healthy first-degree relatives (REL) and 20 healthy subjects (CON) matched according to age and sex of SZO and REL were investigated by applying high-resolution joint symbolic dynamics (HRJSD) analysis. We found a significantly (p<0.0061) altered HR pattern, respiratory pattern and CRCs in SZO and only marginal alterations for the REL group in comparison with the CON group when we applied HRJSD. These results might be an indication of decreased vagal activity within the brainstem, an altered or suppressed interaction of the brainstem and higher regulatory centres, or panic- and anxiety-related changes in the brainstem associated with the acute psychosis of these patients.
精神分裂症作为一种精神疾病，是世界上最严重的疾病之一。精神分裂症患者的心脏死亡率有所上升，但其原因尚不清楚。在急性精神病发作期间，除了其他因素外，自主调节功能受损在不同的应用心率（HR）变异性分析的研究中已变得更加明显。但是，直到现在，对于体内平衡控制很重要的呼吸和心肺调节一直未被考虑。在本研究中，通过应用高分辨率联合符号动力学（HRJSD）分析，对23名未接受药物治疗的偏执型精神分裂症患者（SZO）、20名他们的健康一级亲属（REL）以及20名根据SZO和REL的年龄和性别匹配的健康受试者（CON）的短期心肺耦合（CRC）进行了研究。当我们应用HRJSD时，我们发现SZO组的心率模式、呼吸模式和CRC有显著（p<0.0061）改变，而与CON组相比，REL组仅有轻微改变。这些结果可能表明脑干内迷走神经活动降低、脑干与更高调节中心之间的相互作用改变或受到抑制，或者与这些患者的急性精神病相关的脑干中与恐慌和焦虑相关的变化。
