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精神分裂症患者伴与不伴幻听的睡眠纺锤波缺失特征。

The Feature of Sleep Spindle Deficits in Patients With Schizophrenia With and Without Auditory Verbal Hallucinations.

机构信息

Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China.

Department of Psychiatry, Xijing Hospital, The Air Force Medical University, Xi'an, Shaanxi, China.

出版信息

Biol Psychiatry Cogn Neurosci Neuroimaging. 2023 Mar;8(3):331-342. doi: 10.1016/j.bpsc.2021.07.013. Epub 2021 Aug 8.

Abstract

BACKGROUND

Previous sleep electroencephalography studies have detected abnormalities in sleep architecture and sleep spindle deficits in schizophrenia (SCZ), but the consistency of these results was not robust, which might be due to the small sample size and the influence of clinical factors such as the various medication therapies and symptom heterogeneity. This study aimed to regard auditory verbal hallucinations (AVHs) as a pointcut to downscale the heterogeneity of SCZ and explore whether some sleep architecture and spindle parameters were more severely impaired in SCZ patients with AVHs compared with those without AVHs.

METHODS

A total of 90 SCZ patients with AVHs, 92 SCZ patients without AVHs, and 91 healthy control subjects were recruited, and parameters of sleep architecture and spindle activities were compared between groups. The correlation between significant sleep parameters and clinical indicators was analyzed.

RESULTS

Deficits of sleep spindle activities at prefrontal electrodes and intrahemispheric spindle coherence were observed in both AVH and non-AVH groups, several of which were more serious in the AVH group. In addition, deficits of spindle activities at central and occipital electrodes and interhemispheric spindle coherence mainly manifested accompanying AVH symptoms, most of which were retained in the medication-naive first-episode patients, and were associated with Auditory Hallucination Rating Scale scores.

CONCLUSIONS

Our results suggest that the underlying mechanism of spindle deficits might be different between SCZ patients with and without AVHs. In the future, the sleep feature of SCZ patients with different symptoms and the influence of clinical factors, such as medication therapy, should be further illustrated.

摘要

背景

先前的睡眠脑电图研究已经发现精神分裂症(SCZ)患者在睡眠结构和睡眠纺锤波缺失方面存在异常,但这些结果的一致性并不强,这可能是由于样本量小以及各种药物治疗和症状异质性等临床因素的影响。本研究旨在以听觉言语幻觉(AVH)为切入点,对 SCZ 的异质性进行细分,探讨是否有某些睡眠结构和纺锤波参数在伴有 AVH 的 SCZ 患者中比不伴有 AVH 的患者受损更严重。

方法

共招募了 90 例伴有 AVH 的 SCZ 患者、92 例不伴有 AVH 的 SCZ 患者和 91 名健康对照者,比较了各组的睡眠结构和纺锤波活动参数。分析了显著睡眠参数与临床指标之间的相关性。

结果

在伴有 AVH 和不伴有 AVH 的两组中,均观察到前额叶电极的睡眠纺锤波活动和半球内纺锤波相干性缺陷,其中一些在伴有 AVH 的组中更为严重。此外,中央和枕叶电极的纺锤波活动以及半球间纺锤波相干性的缺陷主要表现为伴有 AVH 症状,其中大部分在未经药物治疗的首发患者中保留,并与听觉幻觉评定量表评分相关。

结论

我们的研究结果表明,伴有和不伴有 AVH 的 SCZ 患者的纺锤波缺失的潜在机制可能不同。未来,应进一步阐明具有不同症状的 SCZ 患者的睡眠特征以及临床因素(如药物治疗)的影响。

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