Dolan R J, Bench C J, Liddle P F, Friston K J, Frith C D, Grasby P M, Frackowiak R S
MRC Cyclotron Unit, Hammersmith Hospital, London, UK.
J Neurol Neurosurg Psychiatry. 1993 Dec;56(12):1290-4. doi: 10.1136/jnnp.56.12.1290.
Neurophysiological deficits in the left dorsolateral prefrontal cortex (DLPFC) have been described in positron emission tomography studies of schizophrenia and depression. In schizophrenia and depression this deficit has been associated with the syndromes of psychomotor poverty and psychomotor retardation, respectively. Such findings lead to a prediction that DLPFC dysfunction is symptom rather than disease related. This prediction was empirically tested in a retrospective study that pooled data from 40 patients meeting research diagnostic criteria for depression and 30 patients meeting DSM-III R criteria for schizophrenia. The patients were categorised into those with and without poverty of speech, a symptom that is an observable manifestation of psychomotor impairment. The profile of regional cerebral blood flow (rCBF), measured in all subjects under resting conditions, was subsequently compared in these two groups. Patients with poverty of speech had significantly lower rCBF in the left DLFPC. This reduction of rCBF was independent of diagnosis. The findings support the view that the study of symptoms, or symptom clusters, can provide information additional to that of traditional diagnostic systems in the study of the major psychoses.
在精神分裂症和抑郁症的正电子发射断层扫描研究中，已描述了左侧背外侧前额叶皮质（DLPFC）的神经生理缺陷。在精神分裂症和抑郁症中，这种缺陷分别与精神运动贫乏和精神运动迟缓综合征相关。这些发现导致一种预测，即DLPFC功能障碍与症状而非疾病相关。在一项回顾性研究中对这一预测进行了实证检验，该研究汇总了40名符合抑郁症研究诊断标准的患者和30名符合精神分裂症DSM-III-R标准的患者的数据。将患者分为有言语贫乏和无言语贫乏两组，言语贫乏是精神运动障碍的一种可观察到的表现症状。随后比较了这两组在静息状态下所有受试者的局部脑血流（rCBF）情况。言语贫乏的患者左侧DLFPC的rCBF显著降低。这种rCBF的降低与诊断无关。这些发现支持了这样一种观点，即在研究主要精神病时，对症状或症状群的研究可以提供传统诊断系统之外的额外信息。
