Iwashiro Norichika, Takano Yosuke, Natsubori Tatsunobu, Aoki Yuta, Yahata Noriaki, Gonoi Wataru, Kunimatsu Akira, Abe Osamu, Kasai Kiyoto, Yamasue Hidenori
Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan,
Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba-city, Chiba, Japan.
Neuropsychiatr Dis Treat. 2019 Feb 14;15:491-502. doi: 10.2147/NDT.S194353. eCollection 2019.
Previous research has suggested that deficits in emotion recognition are involved in the pathogenesis of persecutory delusion in schizophrenia. Although disruption in auditory and language processing is crucial in the pathophysiology of schizophrenia, the neural basis for the deficits in emotion recognition of auditorily presented language stimuli and its relation to persecutory delusion have not yet been clarified.
The current functional magnetic resonance imaging study used a dichotic listening task for 15 patients with schizophrenia and 23 healthy controls matched for age, sex, parental socioeconomic background, handedness, dexterous ear, and intelligence quotient. The participants completed a word recognition task on the attended side in which a word with emotionally valenced content (negative/neutral) was presented to one ear and a different neutral word was presented to the other ear. Participants selectively attended to either ear.
The whole brain analysis detected the aberrant neural activity in the right inferior frontal gyrus in the patients with schizophrenia compared to that in the controls (<0.05, false discovery rate-corrected). Brain activity in the right pars triangularis of the inferior frontal gyrus was significantly reduced when negatively valenced words were presented to the right ear, whereas the activity of the same region was significantly enhanced when these words were presented to the left ear, irrespective of the attended ear, in the participants with schizophrenia compared to the controls. Furthermore, this diminished brain response to auditorily presented negatively valenced words significantly correlated with severe positive symptoms (=-0.67, =0.006) and delusional behavior (=-0.62, =0.014) in the patients with schizophrenia.
The present results indicate that the significantly impaired brain activity in response to auditorily presented negatively valenced words in the right pars triangularis of the inferior frontal gyrus is associated with the pathogenesis of positive symptoms such as persecutory delusion.
先前的研究表明，情绪识别缺陷参与了精神分裂症被害妄想的发病机制。虽然听觉和语言处理障碍在精神分裂症的病理生理学中至关重要，但对于听觉呈现的语言刺激的情绪识别缺陷的神经基础及其与被害妄想的关系尚未阐明。
当前的功能磁共振成像研究对15例精神分裂症患者和23名年龄、性别、父母社会经济背景、利手、优势耳及智商相匹配的健康对照者使用了双耳分听任务。参与者在被关注的一侧完成单词识别任务，其中一个带有情绪效价内容（消极/中性）的单词呈现给一只耳朵，另一个不同的中性单词呈现给另一只耳朵。参与者选择性地关注其中一只耳朵。
全脑分析发现，与对照组相比，精神分裂症患者右侧额下回存在异常神经活动（<0.05，错误发现率校正）。当消极效价单词呈现给右耳时，精神分裂症患者与对照组相比，右侧额下回三角部的脑活动显著降低；而当这些单词呈现给左耳时，无论被关注的耳朵是哪只，该区域的活动均显著增强。此外，精神分裂症患者对听觉呈现的消极效价单词的脑反应减弱与严重的阳性症状（=-0.6[具体单位未给出]，=0.006）和妄想行为（=-0.62，=0.014）显著相关。
目前的结果表明，右侧额下回三角部对听觉呈现的消极效价单词的脑活动显著受损与被害妄想等阳性症状的发病机制有关。
