Ford Judith M
1 San Francisco Veterans Administration Medical Center, San Francisco, CA, USA.
2 University of California, San Francisco, San Francisco, CA, USA.
Clin EEG Neurosci. 2018 Jan;49(1):6-7. doi: 10.1177/1550059417737416. Epub 2017 Nov 2.
It has been surprisingly difficult to find associations between neural signatures of schizophrenia and the symptoms that define it. That is, many of the legacy components of the event-related potential (ERP)- P50, N100, P200, P300-are reduced in patients with schizophrenia, in first-degree relatives of patients with schizophrenia, in schizophrenia patients early in their illness, and even in people at clinical high risk for schizophrenia. Nevertheless, these ERP components tend to be relatively insensitive to symptoms. This might be due to a number of reasons. First, this could reflect a lack of relationship, a failure to report disappointing findings, or a failure to test for relationships. Second, many ERP studies were not designed to be sensitive to symptoms or to the mechanisms that might underlie them. Third, assessing symptoms is sometimes dependent on the patients' ability to describe unfathomable experiences and the clinicians' ability to understand and interpret them. Fourth, medications and comorbidities may decouple the symptoms from the neurobiology. Finally, we must also consider the possibility that the schizophrenia diagnosis breeds truer than the symptoms it comprises.
令人惊讶的是，很难找到精神分裂症的神经特征与定义该疾病的症状之间的关联。也就是说，事件相关电位（ERP）的许多传统成分——P50、N100、P200、P300——在精神分裂症患者、精神分裂症患者的一级亲属、病程早期的精神分裂症患者，甚至处于精神分裂症临床高危状态的人群中都会降低。然而，这些ERP成分往往对症状相对不敏感。这可能有多种原因。首先，这可能反映出两者之间缺乏关联、未能报告令人失望的研究结果，或者未能对两者之间的关系进行检验。其次，许多ERP研究并非设计用于对症状或可能构成症状基础的机制敏感。第三，评估症状有时取决于患者描述难以理解的经历的能力以及临床医生理解和解释这些经历的能力。第四，药物治疗和共病可能会使症状与神经生物学脱钩。最后，我们还必须考虑这样一种可能性，即精神分裂症的诊断比其包含的症状更为真实。
