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分裂型人格障碍患者的惊跳前脉冲抑制和习惯化受损。

Impaired startle prepulse inhibition and habituation in patients with schizotypal personality disorder.

作者信息

Cadenhead K S, Geyer M A, Braff D L

机构信息

Department of Psychiatry, University of California, San Diego, La Jolla 92093-0603.

出版信息

Am J Psychiatry. 1993 Dec;150(12):1862-7. doi: 10.1176/ajp.150.12.1862.

Abstract

OBJECTIVE

Information processing measures that serve as biological markers for schizophrenia can help to define the boundaries of schizophrenia. Prepulse inhibition and habituation of the blink reflex component of startle, which are thought to reflect an individual's ability to screen out or "gate" irrelevant sensory stimuli, are impaired in patients with schizophrenia. These deficits in sensorimotor gating and habituation in schizophrenic patients may lead to sensory overload and, secondarily, cognitive fragmentation, disorganization, and thought disorder. The goal of this study was to test two hypotheses: 1) patients with schizotypal personality disorder would show a loss of sensorimotor gating reflected by impaired prepulse inhibition of the human startle response and 2) patients with schizotypal personality disorder would show deficits in startle habituation consistent with the deficits seen in patients with schizophrenia.

METHOD

Prepulse inhibition and habituation were assessed in 12 men and four women who met DSM-III-R criteria for schizotypal personality disorder and in 22 normal comparison subjects.

RESULTS

Patients with schizotypal personality disorder had deficits in acoustic prepulse inhibition and habituation similar to the deficits observed in patients with schizophrenia. Although there were no differences between patients with schizotypal personality disorder and normal subjects in latency from acoustic startle stimuli to response, latency facilitation was produced by the prepulse in both groups.

CONCLUSIONS

This pattern of changes in amplitude and latency of the startle response suggests that subjects with schizotypal personality disorder perceive the prepulse stimuli but still demonstrate deficient sensorimotor gating of amplitude. These findings support the importance of startle prepulse inhibition and startle habituation as biological markers for schizophrenia spectrum disorders.

摘要

目的

作为精神分裂症生物学标志物的信息处理指标有助于界定精神分裂症的边界。预备脉冲抑制和惊跳反射眨眼成分的习惯化被认为反映了个体筛选或“门控”无关感觉刺激的能力,精神分裂症患者存在这些方面的损害。精神分裂症患者感觉运动门控和习惯化的这些缺陷可能导致感觉过载,进而导致认知碎片化、紊乱和思维障碍。本研究的目的是检验两个假设:1)分裂型人格障碍患者会表现出感觉运动门控丧失,表现为人类惊跳反应的预备脉冲抑制受损;2)分裂型人格障碍患者会表现出惊跳习惯化缺陷,与精神分裂症患者所见的缺陷一致。

方法

对12名男性和4名女性进行预备脉冲抑制和习惯化评估,这些人符合分裂型人格障碍的DSM-III-R标准,并与22名正常对照受试者进行比较。

结果

分裂型人格障碍患者在听觉预备脉冲抑制和习惯化方面存在缺陷,与精神分裂症患者观察到的缺陷相似。虽然分裂型人格障碍患者与正常受试者在听觉惊跳刺激到反应的潜伏期上没有差异,但两组中预备脉冲均产生了潜伏期易化。

结论

这种惊跳反应幅度和潜伏期的变化模式表明,分裂型人格障碍受试者能感知预备脉冲刺激,但在幅度的感觉运动门控方面仍表现出缺陷。这些发现支持了惊跳预备脉冲抑制和惊跳习惯化作为精神分裂症谱系障碍生物学标志物的重要性。

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