Carter O, Bennett D, Nash T, Arnold S, Brown L, Cai R Y, Allan Z, Dluzniak A, McAnally K, Burr D, Sundram S
Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia.
Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.
Transl Psychiatry. 2017 May 9;7(5):e1118. doi: 10.1038/tp.2017.69.
Visual dysfunction is commonplace in schizophrenia and occurs alongside cognitive, psychotic and affective symptoms of the disorder. Psychophysical evidence suggests that this dysfunction results from impairments in the integration of low-level neural signals into complex cortical representations, which may also be associated with symptom formation. Despite the symptoms of schizophrenia occurring in a range of disorders, the integration deficit has not been tested in broader patient populations. Moreover, it remains unclear whether such deficits generalize across other sensory modalities. The present study assessed patients with a range of psychotic and nonpsychotic disorders and healthy controls on visual contrast detection, visual motion integration, auditory tone detection and auditory tone integration. The sample comprised a total of 249 participants (schizophrenia spectrum disorder n=98; bipolar affective disorder n=35; major depression n=31; other psychiatric conditions n=31; and healthy controls n=54), of whom 178 completed one or more visual task and 71 completed auditory tasks. Compared with healthy controls and nonpsychotic patients, psychotic patients trans-diagnostically were impaired on both visual and auditory integration, but unimpaired in simple visual or auditory detection. Impairment in visual motion integration was correlated with the severity of positive symptoms, and could not be accounted for by a reduction in processing speed, inattention or medication effects. Our results demonstrate that impaired sensory integration is not specific to schizophrenia, as has previously been assumed. Instead, sensory deficits are closely related to the presence of positive symptoms independent of diagnosis. The finding that equivalent integrative sensory processing is impaired in audition is consistent with hypotheses that propose a generalized deficit of neural integration in psychotic disorders.
视觉功能障碍在精神分裂症中很常见,且与该疾病的认知、精神病性及情感症状同时出现。心理物理学证据表明,这种功能障碍是由于低水平神经信号整合到复杂皮质表征过程中出现损伤所致,这也可能与症状形成有关。尽管精神分裂症的症状出现在一系列疾病中,但尚未在更广泛的患者群体中测试整合缺陷。此外,尚不清楚这种缺陷是否会在其他感觉模态中普遍存在。本研究对患有一系列精神病性和非精神病性疾病的患者以及健康对照者进行了视觉对比度检测、视觉运动整合、听觉音调检测和听觉音调整合方面的评估。样本总共包括249名参与者(精神分裂症谱系障碍患者n = 98;双相情感障碍患者n = 35;重度抑郁症患者n = 31;其他精神疾病患者n = 31;健康对照者n = 54),其中178人完成了一项或多项视觉任务,71人完成了听觉任务。与健康对照者和非精神病性患者相比,跨诊断的精神病性患者在视觉和听觉整合方面均受损,但在简单的视觉或听觉检测方面未受损。视觉运动整合受损与阳性症状的严重程度相关,且不能用处理速度减慢、注意力不集中或药物作用来解释。我们的结果表明,感觉整合受损并非如先前假设的那样是精神分裂症所特有的。相反,感觉缺陷与阳性症状的存在密切相关,与诊断无关。在听觉方面等效的整合感觉处理受损这一发现与提出精神病性障碍中存在普遍神经整合缺陷的假设一致。