精神分裂症和精神病减弱综合征中的运动加工受损：病因学和临床意义。
Impaired Motion Processing in Schizophrenia and the Attenuated Psychosis Syndrome: Etiological and Clinical Implications.
机构信息
From the Nathan Kline Institute for Psychiatric Research, Orangeburg, N.Y.; the Department of Psychiatry, Columbia University Medical Center, New York; the Department of Psychiatry, School of Medicine, University of Chile, Santiago; the Department of Neurosciences, University of California, San Diego, La Jolla; the School of Psychology, University of Aberdeen, Aberdeen, United Kingdom; the Facultad de Ingeniería, Universidad Autónoma de Chile, Talca; and the Icahn School of Medicine at Mount Sinai, New York.
出版信息
Am J Psychiatry. 2018 Dec 1;175(12):1243-1254. doi: 10.1176/appi.ajp.2018.18010072. Epub 2018 Oct 3.
OBJECTIVE
The ability to perceive the motion of biological objects, such as faces, is a critical component of daily function and correlates with the ability to successfully navigate social situations (social cognition). Deficits in motion perception in schizophrenia were first demonstrated about 20 years ago but remain understudied, especially in the early, potentially prodromal, stages of the illness. The authors examined the neural bases of visual sensory processing impairments, including motion, in patients with schizophrenia (N=63) and attenuated psychosis (clinical high risk) (N=32) compared with age-matched healthy control subjects (N=67).
METHOD
Electrophysiological recordings during stimulus and motion processing were analyzed using oscillatory (time frequency) approaches that differentiated motion-onset-evoked activity from stimulus-onset sensory-evoked responses. These were compared with functional MRI (fMRI) measures of motion processing.
RESULTS
Significant deficits in motion processing were observed across the two patient groups, and these deficits predicted impairments in both face-emotion recognition and cognitive function. In contrast to motion processing, sensory-evoked stimulus-onset responses were intact in patients with attenuated psychosis, and, further, the relative deficit in motion-onset responses compared with stimulus-onset responses predicted transition to schizophrenia. In patients with schizophrenia, motion detection deficits mapped to impaired activation in motion-sensitive visual cortex during fMRI. Additional visual impairments in patients with schizophrenia, not present in patients with attenuated psychosis, implicated other visual regions, including the middle occipital gyrus and pulvinar thalamic nucleus.
CONCLUSIONS
The study findings emphasize the importance of sensory-level visual dysfunction in the etiology of schizophrenia and in the personal experience of individuals with the disorder and demonstrate that motion-processing deficits may predate illness onset and contribute to impaired function even in patients with attenuated psychosis.
目的
感知生物物体（如人脸）运动的能力是日常功能的关键组成部分，与成功处理社交情境（社会认知）的能力相关。大约 20 年前首次证明了精神分裂症患者在运动感知方面存在缺陷，但研究仍不够充分，尤其是在疾病的早期、潜在前驱阶段。作者比较了精神分裂症患者（N=63）和有衰减精神病（临床高风险）（N=32）与年龄匹配的健康对照组（N=67），检查了视觉感觉处理障碍（包括运动）的神经基础。
方法
使用振荡（时频）方法分析刺激和运动处理期间的电生理记录，该方法将运动诱发活动与刺激诱发的感觉反应区分开来。将这些与运动处理的功能磁共振成像（fMRI）测量值进行了比较。
结果
两个患者组都观察到运动处理的明显缺陷，这些缺陷预测了面部情绪识别和认知功能的损伤。与运动处理相反，衰减精神病患者的感觉诱发刺激起始反应完整，而且，与刺激起始反应相比，运动起始反应的相对缺陷预测了向精神分裂症的转变。在精神分裂症患者中，运动检测缺陷映射到 fMRI 中运动敏感视觉皮层的激活受损。精神分裂症患者存在的其他视觉损伤（衰减精神病患者不存在）暗示了其他视觉区域，包括中枕叶和丘脑枕核。
结论
研究结果强调了感觉水平视觉功能障碍在精神分裂症发病机制中的重要性，以及在该疾病患者的个人体验中的重要性，并表明运动处理缺陷可能先于发病出现，并导致即使在衰减精神病患者中功能受损。
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