Erkwoh R, Sabri O, Steinmeyer E M, Bull U, Sass H
Department of Psychiatry and Psychotherapy, Aachen University of Technology, Germany.
Acta Psychiatr Scand. 1997 Jul;96(1):51-7. doi: 10.1111/j.1600-0447.1997.tb09904.x.
A total of 24 never-treated (i.e. drug-naive) actively psychotic schizophrenic patients, operationalized according to DSM-III-R, were examined in a pre-post-treatment design using the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) and 99mTc-HMPAO-single photon emission computed tomography (SPECT) to assess regional cerebral blood flow (rCBF). The control subjects were 20 patients free of neurological and psychiatric symptoms. Before treatment there was only a slight hypofrontality, and hypoperfusion was observed in the left temporal superior region. After treatment, hypofrontality was reduced to one region and temporal hypoperfusion disappeared. Formal thought disorders were accompanied by increased rCBF in the bilateral frontal interior and left temporal superior regions. Delusions were associated with hypoperfusion in the anterior cingulate cortex. Negative symptoms showed no linkage to hypofrontality, either before or after treatment. Factor analysis showed delusions and hallucinations loading on different dimensions. The disorganized dimension correlated positively with all regions of interest, whereas these were negatively correlated with reality distortion.
共有24名从未接受过治疗（即未用过药）的处于活动期精神病性症状的精神分裂症患者，按照DSM - III - R标准进行诊断，采用精神分裂症阳性和阴性症状量表（PANSS）以及99mTc - HMPAO单光子发射计算机断层扫描（SPECT），以评估局部脑血流量（rCBF），在治疗前后设计中对其进行检查。对照组为20名无神经和精神症状的患者。治疗前仅存在轻微的额叶功能低下，且在左侧颞叶上部区域观察到灌注不足。治疗后，额叶功能低下减少至一个区域，颞叶灌注不足消失。形式思维障碍伴随着双侧额叶内侧和左侧颞叶上部区域rCBF增加。妄想与前扣带回皮质灌注不足相关。阴性症状在治疗前后均与额叶功能低下无关联。因子分析显示妄想和幻觉加载在不同维度上。紊乱维度与所有感兴趣区域呈正相关，而这些区域与现实扭曲呈负相关。
