Chu Ryan Sai-Ting, Ng Chung-Mun, Chan Kwun-Nam, Chan Kit-Wa, Lee Ho-Ming, Hui Lai-Ming, Chen Eric, Chang Wing-Chung
Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.
Brain Sci. 2021 Oct 20;11(11):1370. doi: 10.3390/brainsci11111370.
Emerging evidence has indicated disrupted learned irrelevance (LIrr), a form of selective attention deficit that may contribute to psychotic symptom formation, in schizophrenia. However, previous research mostly focused on chronic patients. There is a paucity of studies on LIrr in first-episode schizophrenia-spectrum disorder (i.e., schizophrenia and schizophreniform disorder; FES), which were limited by small sample size and have produced mixed results. The current study examined a LIrr effect and its relationship with positive symptom severity in 40 briefly-medicated FES patients and 42 demographically-matched healthy controls using a well-validated computerized LIrr paradigm which has been applied in chronic schizophrenia sample. Positive symptoms were assessed by Positive and Negative Syndrome Scale (PANSS) and Psychotic Symptom Rating Scales (PSYRATS). Our results showed that controls demonstrated intact LIrr, with significantly faster learning about previously predictive (relevant) than previously non-predictive (irrelevant) cues. Lack of such normal attention bias towards predictive over non-predictive cues was observed in FES patients, indicating their failure to distinguish between relevant and irrelevant stimuli. Nonetheless, we failed to reveal any significant correlations between learning scores, in particular learning scores for non-predictive cues, and positive symptom measures in FES patients. Learning scores were also not associated with other symptom dimensions, cognitive functions and antipsychotic dose. In conclusion, our findings indicate aberrant LIrr with impaired allocation of attention to relevant versus irrelevant stimuli in briefly-medicated FES patients. Further prospective research is warranted to clarify the longitudinal trajectory of such selective attention deficit and its association with positive symptoms and treatment response in the early course of illness.
新出现的证据表明，精神分裂症患者存在习得性无关信息处理障碍（LIrr），这是一种选择性注意力缺陷，可能导致精神病性症状的形成。然而，以往的研究大多集中在慢性患者身上。关于首发精神分裂症谱系障碍（即精神分裂症和精神分裂症样障碍；FES）中LIrr的研究较少，这些研究受样本量小的限制，结果也不一致。本研究使用一种经过充分验证的计算机化LIrr范式，对40例短期服药的FES患者和42例人口统计学匹配的健康对照进行了LIrr效应及其与阳性症状严重程度关系的研究，该范式已应用于慢性精神分裂症样本。通过阳性和阴性症状量表（PANSS）和精神病性症状评定量表（PSYRATS）评估阳性症状。我们的结果显示，对照组的LIrr功能正常，对先前有预测性（相关）线索的学习明显快于先前无预测性（无关）线索。FES患者未观察到对预测性线索比对非预测性线索有这种正常的注意力偏向，表明他们无法区分相关刺激和无关刺激。尽管如此，我们未能发现FES患者的学习分数，特别是非预测性线索的学习分数与阳性症状测量之间有任何显著相关性。学习分数也与其他症状维度、认知功能和抗精神病药物剂量无关。总之，我们的研究结果表明，短期服药的FES患者存在异常的LIrr，对相关刺激和无关刺激的注意力分配受损。有必要进行进一步的前瞻性研究，以阐明这种选择性注意力缺陷在疾病早期的纵向轨迹及其与阳性症状和治疗反应的关系。
