Yu Miao, Tang XiaoWei, Wang Xiang, Zhang XiangRong, Zhang XiaoBin, Sha WeiWei, Yao ShuQiao, Shu Ni, Zhang XiangYang, Zhang ZhiJun
Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
Department of Psychiatry, Wutaishan Hospital of Yangzhou, Yangzhou, Jiangsu, China.
PLoS One. 2015 Sep 18;10(9):e0138357. doi: 10.1371/journal.pone.0138357. eCollection 2015.
Deficit schizophrenia (DS) has been proposed as a pathophysiologically distinct subgroup within schizophrenia. Earlier studies focusing on neurocognitive function of DS patients have yielded inconsistent findings ranging from substantial deficits to no significant difference relative to non-deficit schizophrenia patients (NDS). The present study investigated the severity and characteristic patterns of neurocognitive impairments in DS and NDS patients and their relationships with clinical variables.
Attention, ideation fluency, cognitive flexibility and visuospatial memory function were assessed in 40 DS patients, 57 NDS patients, and 52 healthy controls by a comprehensive neuropsychological battery.
Both schizophrenia subgroups had overall more severe cognitive impairments than controls while DS performed worse on every neuropsychological measure except the Stroop interference than the NDS patients with age and education as the covariates. Profile analysis found significantly different patterns of cognitive profiles between two patients group mainly due to their differences in attention and cognitive flexibility functions. Age, education, illness duration and negative symptoms were found to have the correlations with cognitive impairments in the NDS group, while only age and the negative symptoms were correlated with the cognitive impairments in the DS group. Multiple regression analyses revealed that sustained attention and cognitive flexibility were the core impaired cognitive domains mediating other cognitive functions in DS and NDS patients respectively.
DS patients exemplified worse in almost all cognitive domains than NDS patients. Sustained attention and cognitive flexibility might be the key impaired cognitive domains for DS and NDS patients respectively. The present study suggested the DS as a specific subgroup of schizophrenia.
缺损型精神分裂症（DS）被认为是精神分裂症中在病理生理上具有独特性的亚组。早期针对DS患者神经认知功能的研究结果并不一致，与非缺损型精神分裂症患者（NDS）相比，既有显著缺损，也有未发现显著差异的情况。本研究调查了DS和NDS患者神经认知损害的严重程度和特征模式及其与临床变量的关系。
通过一套综合神经心理测试，对40例DS患者、57例NDS患者和52名健康对照者的注意力、思维流畅性、认知灵活性和视觉空间记忆功能进行评估。
两个精神分裂症亚组的认知损害总体上都比对照组更严重，在以年龄和教育程度作为协变量的情况下，除了斯特鲁普干扰任务外，DS患者在各项神经心理测试中的表现均比NDS患者差。轮廓分析发现，两组患者的认知轮廓模式存在显著差异，主要是由于他们在注意力和认知灵活性功能方面存在差异。研究发现，年龄、教育程度、病程和阴性症状与NDS组的认知损害相关，而在DS组中，只有年龄和阴性症状与认知损害相关。多元回归分析显示，持续性注意力和认知灵活性分别是DS和NDS患者中调节其他认知功能的核心受损认知领域。
DS患者在几乎所有认知领域的表现都比NDS患者差。持续性注意力和认知灵活性可能分别是DS和NDS患者受损的关键认知领域。本研究表明DS是精神分裂症的一个特定亚组。
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