Cannon T D, Zorrilla L E, Shtasel D, Gur R E, Gur R C, Marco E J, Moberg P, Price R A
Department of Psychology, University of Pennsylvania, Philadelphia.
Arch Gen Psychiatry. 1994 Aug;51(8):651-61. doi: 10.1001/archpsyc.1994.03950080063009.
To determine whether schizophrenics and their nonschizophrenic siblings have a similar pattern of neuropsychological deficit when compared with normal controls.
Fifteen probands with schizophrenia, 16 of their nonschizophrenic siblings, and 31 unrelated, demographically balanced, normal individuals underwent evaluation with a comprehensive neuropsychological test battery. All subjects were screened for history of head injury, neurologic illness, major medical conditions, substance use, and axis I psychiatric disorders other than schizophrenia. Probands underwent evaluation twice: once at intake when half had never received neuroleptic medication and the other half had received none for a minimum of 2 weeks, and again at the 2- to 4-week follow-up, after stabilization with neuroleptic medications.
Both schizophrenics and their nonschizophrenic siblings were impaired neuropsychologically compared with normal controls, with the nonschizophrenic siblings' performance intermediate between that of the schizophrenic siblings and the normal controls on all measures of functioning. The shapes of the deficit profiles of schizophrenic patients and their siblings were similar; in patients, verbal memory, abstraction, attention, and language functions were significantly more affected compared with spatial abilities, spatial memory, and sensory-motor functions, with a nonsignificant trend in the same direction in siblings. Cognitive functioning in patients was found to be stable across changes in medication status and clinical state. Four fifths of patients obtained more deviant scores than their nonschizophrenic siblings. Among the sibling group, those with probable and certain diagnoses of schizotypal personality disorder were more impaired compared with those without schizophrenia-spectrum symptoms.
These results support the hypothesis that impaired information processing aggregates in the family members of schizophrenics and may serve as an indicator of genetic vulnerability to the disorder. Further work is needed to establish whether particular areas of functioning are selectively impaired in relatives and to determine whether the performance deficits are mediated by structural and/or metabolic disturbances in specific brain regions.
确定与正常对照组相比，精神分裂症患者及其非精神分裂症的兄弟姐妹是否具有相似的神经心理缺陷模式。
15名精神分裂症先证者、他们的16名非精神分裂症兄弟姐妹以及31名无亲缘关系、人口统计学特征均衡的正常个体接受了一套全面的神经心理测试。所有受试者均接受了头部受伤史、神经系统疾病、重大躯体疾病、物质使用情况以及除精神分裂症之外的轴I精神障碍筛查。先证者接受了两次评估：一次在入组时，一半受试者从未接受过抗精神病药物治疗，另一半至少两周未接受治疗；另一次在2至4周随访时，即在使用抗精神病药物病情稳定之后。
与正常对照组相比，精神分裂症患者及其非精神分裂症的兄弟姐妹在神经心理方面均存在损害，在所有功能测量指标上，非精神分裂症兄弟姐妹的表现介于精神分裂症患者的兄弟姐妹和正常对照组之间。精神分裂症患者及其兄弟姐妹的缺陷模式形状相似；在患者中，与空间能力、空间记忆和感觉运动功能相比，言语记忆、抽象思维、注意力和语言功能受影响更显著，兄弟姐妹中也有相同方向的不显著趋势。发现患者的认知功能在药物状态和临床状态变化过程中保持稳定。五分之四的患者得分比其非精神分裂症的兄弟姐妹更偏离正常。在兄弟姐妹组中，与没有精神分裂症谱系症状的人相比，可能或肯定诊断为分裂型人格障碍的人受损更严重。
这些结果支持以下假设，即信息处理受损在精神分裂症患者的家庭成员中聚集，可能作为该疾病遗传易感性的一个指标。需要进一步开展工作，以确定亲属中特定功能领域是否存在选择性损害，并确定表现缺陷是否由特定脑区的结构和/或代谢紊乱介导。
