Kremen W S, Seidman L J, Pepple J R, Lyons M J, Tsuang M T, Faraone S V
Psychiatry Service, Harvard Medical School/Brockton-West Roxbury VA Medical Center, MA 02401.
Schizophr Bull. 1994;20(1):103-19. doi: 10.1093/schbul/20.1.103.
We reviewed potential neuropsychological risk indicators for schizophrenia by addressing two broad questions about neuropsychological performance in biological relatives of schizophrenia patients: (1) Is there evidence of deficits, and, if so, (2) are those deficits similar to deficits found in schizophrenia patients themselves? There has not yet been adequate validation of most neuropsychological risk indicators, but promising leads have emerged from studies of relatives of persons with schizophrenia. The strongest evidence of impairment in relatives was in sustained attention, perceptual-motor speed, and concept formation and abstraction; to a slightly lesser extent, mental control/encoding (primarily with distraction) was implicated as well. Impairments in verbal memory and verbal fluency were also found, although these have been less well studied. The pattern of deficits paralleled that found in schizophrenia patients, thus suggesting dysfunction in prefrontal, temporal-limbic, and attentional systems. Findings were similar for children and adult relatives of schizophrenia patients. It is suggested that future studies (1) emphasize comprehensive test batteries, (2) develop composite neuropsychological measures, (3) use profile and deviant-responder analyses, (4) include psychiatric comparison groups, and (5) integrate neuropsychological assessments with brain imaging techniques.
我们通过探讨有关精神分裂症患者生物学亲属神经心理表现的两个广泛问题，回顾了精神分裂症潜在的神经心理风险指标：（1）是否有缺陷的证据，如果有，（2）这些缺陷是否与在精神分裂症患者自身中发现的缺陷相似？大多数神经心理风险指标尚未得到充分验证，但对精神分裂症患者亲属的研究已出现了有前景的线索。亲属中损害的最有力证据存在于持续注意力、感知运动速度以及概念形成与抽象方面；在稍小程度上，心理控制/编码（主要是在有干扰的情况下）也受到牵连。言语记忆和言语流畅性方面也发现了损害，尽管对这些方面的研究较少。缺陷模式与在精神分裂症患者中发现的模式相似，从而表明前额叶、颞叶边缘和注意力系统存在功能障碍。精神分裂症患者的儿童和成年亲属的研究结果相似。建议未来的研究：（1）强调综合测试组，（2）开发综合神经心理测量方法，（3）使用剖面图和异常反应者分析，（4）纳入精神病学比较组，以及（5）将神经心理评估与脑成像技术相结合。
