Gur R E, Resnick S M, Gur R C
Department of Psychiatry, University of Pennsylvania, Philadelphia 19104-4283.
Psychiatry Res. 1989 Mar;27(3):325-34. doi: 10.1016/0165-1781(89)90147-9.
Two of the hypotheses on regional brain dysfunction in schizophrenia that have received some support in studies of cerebral blood flow (CBF) and cerebral metabolic rate (CMR) are: (1) left hemispheric dysfunction and overactivation (laterality) and (2) frontal lobe deactivation or failure to activate (frontality). Although these hypotheses are not mutually exclusive, their relative importance for providing clues to neural underpinnings of symptoms specific to schizophrenia depends on their ability to predict variation in symptomatology. A potentially efficient strategy for such study is to start with physiological parameters of laterality and frontality, and correlate them with measures of severity of clinical symptoms specific to schizophrenia. For two schizophrenic samples reported earlier, we derived laterality (left-right hemispheres) and frontality (frontal-posterior regions) measures of CBF (Study 1) and CMR (Study 2), and correlated them with symptom specificity, defined as the difference in severity of symptoms specific and nonspecific to schizophrenia assessed by the Brief Psychiatric Rating Scale. In both studies, low but significant positive correlations were obtained between the specificity score and laterality for CBF in Study 1 and for CMR in Study 2, but not frontality. The results suggest that in these samples disturbances in lateralized activity are more prominently associated with the phenomenology of schizophrenia than disturbed frontal lobe activity.
在精神分裂症的大脑区域功能障碍方面，有两个假说在脑血流量（CBF）和脑代谢率（CMR）研究中得到了一定支持，它们分别是：（1）左半球功能障碍和过度激活（偏侧性），以及（2）额叶失活或未能激活（额叶性）。虽然这些假说并非相互排斥，但它们对于揭示精神分裂症特有症状的神经基础的相对重要性，取决于它们预测症状学变化的能力。进行此类研究的一个潜在有效策略是，从偏侧性和额叶性的生理参数入手，并将它们与精神分裂症特有的临床症状严重程度的测量指标相关联。对于之前报道的两个精神分裂症样本，我们得出了CBF（研究1）和CMR（研究2）的偏侧性（左右半球）和额叶性（额-后区域）测量指标，并将它们与症状特异性相关联，症状特异性定义为通过简明精神病评定量表评估的精神分裂症特异性和非特异性症状严重程度的差异。在两项研究中，研究1中CBF的特异性得分与偏侧性之间，以及研究2中CMR的特异性得分与偏侧性之间，均获得了低但显著的正相关，与额叶性则未获得相关。结果表明，在这些样本中，与精神分裂症的现象学更显著相关的是偏侧化活动的紊乱，而非额叶活动的紊乱。
