Berman I, Viegner B, Merson A, Allan E, Pappas D, Green A I
Taunton State Hospital, Harvard Medical School, MA 02780-0997, USA.
Schizophr Res. 1997 May 3;25(1):1-10. doi: 10.1016/S0920-9964(96)00098-9.
This study assessed the relationships between positive and negative clinical symptoms and specific neuropsychological deficits in a group of stable schizophrenic patients.
Thirty patients were assessed using the Positive and Negative Syndrome Scale (PANSS) for schizophrenia and a battery of cognitive tests. The PANSS assessments were done by a group of raters blind to the results of cognitive tests, while the cognitive tests were conducted by a different group of raters who remained blind to the PANSS scores.
We found that, although positive and negative symptoms showed a trend toward direct correlation with each other, they correlated with distinct cognitive deficits. Patients with higher negative scores had more perseverative responses, perservative errors, and completed fewer categories on the Wisconsin Card Sorting Test; they also experienced more difficulties on trail making and verbal fluency tests. On the other hand, positive symptoms were associated with poor performance on the Digit Span, particularly the Digit Span Forward.
Our findings are in agreement with previous reports that negative symptoms may be associated with poor performance on cognitive tests reflecting particularly frontal function. Positive symptoms, on the other hand, seem to be associated with poor attention, specifically of auditory type, and thus, possibly with dysfunction within the more widespread neural networks underlying attention. Our findings support the hypothesis that positive and negative symptoms may be associated with distinct neuropsychological deficits and thus with distinct neurological substrates and point to the need to address both positive and negative dimensions when studying schizophrenia.
本研究评估了一组稳定的精神分裂症患者的阳性和阴性临床症状与特定神经心理学缺陷之间的关系。
使用精神分裂症阳性和阴性症状量表（PANSS）及一系列认知测试对30名患者进行评估。PANSS评估由一组对认知测试结果不知情的评估者进行，而认知测试由另一组对PANSS分数不知情的评估者进行。
我们发现，尽管阳性和阴性症状呈现出相互直接关联的趋势，但它们与不同的认知缺陷相关。阴性得分较高的患者在威斯康星卡片分类测试中有更多的持续性反应、持续性错误，完成的类别更少；他们在连线测验和言语流畅性测试中也遇到更多困难。另一方面，阳性症状与数字广度测试表现不佳相关，尤其是顺背数字广度。
我们的研究结果与先前的报告一致，即阴性症状可能与反映特别是额叶功能的认知测试表现不佳有关。另一方面，阳性症状似乎与注意力不集中有关，特别是听觉类型的注意力，因此，可能与更广泛的注意力基础神经网络功能障碍有关。我们的研究结果支持这样的假设，即阳性和阴性症状可能与不同的神经心理学缺陷相关，从而与不同的神经学基质相关，并指出在研究精神分裂症时需要同时关注阳性和阴性维度。
