Tikàsz Andràs, Potvin Stéphane, Lungu Ovidiu, Joyal Christian C, Hodgins Sheilagh, Mendrek Adrianna, Dumais Alexandre
Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Trois-Rivières, QC, Canada; Department of Psychiatry, University of Montreal, Trois-Rivières, QC, Canada.
Department of Psychiatry, University of Montreal, Trois-Rivières, QC, Canada; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Trois-Rivières, QC, Canada; Centre for Research in Aging, Donald Berman Maimonides Geriatric Centre, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.
Neuropsychiatr Dis Treat. 2016 Jun 15;12:1397-410. doi: 10.2147/NDT.S107545. eCollection 2016.
Evidence suggests a 2.1-4.6 times increase in the risk of violent behavior in schizophrenia compared to the general population. Current theories propose that the processing of negative emotions is defective in violent individuals and that dysfunctions within the neural circuits involved in emotion processing are implicated in violence. Although schizophrenia patients show enhanced sensitivity to negative stimuli, there are only few functional neuroimaging studies that have examined emotion processing among men with schizophrenia and a history of violence.
The present study aimed to identify the brain regions with greater neurofunctional alterations, as detected by functional magnetic resonance imaging during an emotion processing task, of men with schizophrenia who had engaged in violent behavior compared with those who had not.
Sixty men were studied; 20 with schizophrenia and a history of violence, 19 with schizophrenia and no violence, and 21 healthy men were scanned while viewing positive, negative, and neutral images.
Negative images elicited hyperactivations in the anterior cingulate cortex (ACC), left and right lingual gyrus, and the left precentral gyrus in violent men with schizophrenia, compared to nonviolent men with schizophrenia and healthy men. Neutral images elicited hyperactivations in the right and left middle occipital gyrus, left lingual gyrus, and the left fusiform gyrus in violent men with schizophrenia, compared to the other two groups.
Violent men with schizophrenia displayed specific increases in ACC in response to negative images. Given the role of the ACC in information integration, these results indicate a specific dysfunction in the processing of negative emotions that may trigger violent behavior in men with schizophrenia.
有证据表明，与普通人群相比，精神分裂症患者出现暴力行为的风险增加了2.1至4.6倍。当前理论认为，暴力个体的负面情绪处理存在缺陷，且情绪处理相关神经回路的功能障碍与暴力行为有关。尽管精神分裂症患者对负面刺激表现出更高的敏感性，但仅有少数功能神经影像学研究考察了有暴力史的精神分裂症男性患者的情绪处理情况。
本研究旨在通过功能磁共振成像，确定在情绪处理任务中，有暴力行为的精神分裂症男性患者与无暴力行为的患者相比，神经功能改变更大的脑区。
对60名男性进行了研究；其中20名有精神分裂症且有暴力史，19名有精神分裂症但无暴力史，21名健康男性在观看正性、负性和中性图像时接受了扫描。
与无暴力行为的精神分裂症男性患者和健康男性相比，有暴力行为的精神分裂症男性患者在观看负性图像时，前扣带回皮质（ACC）、左右舌回和左侧中央前回出现了激活增强。与其他两组相比，有暴力行为的精神分裂症男性患者在观看中性图像时，左右枕中回、左侧舌回和左侧梭状回出现了激活增强。
有暴力行为的精神分裂症男性患者在观看负性图像时，ACC出现了特异性激活增强。鉴于ACC在信息整合中的作用，这些结果表明，在处理可能引发精神分裂症男性暴力行为的负面情绪方面存在特异性功能障碍。
