Gilbertson M W, van Kammen D P
Highland Drive Veterans Affairs Medical Center, Pittsburgh, PA 15206, USA.
Biol Psychiatry. 1997 Oct 1;42(7):585-95. doi: 10.1016/S0006-3223(96)00435-0.
Neuropsychological measures of recent and remote memory as well as general attention were administered to two groups of DSM-III-R schizophrenic patients in a within-subject repeated measures design across a 3-week interval. One group of patients (n = 12) was maintained on haloperidol for both test sessions, whereas a second group (n = 9) was tested first on haloperidol and again 3-weeks drug free. Patients received no adjunctive anticholinergic medication during the study. No differences were observed between the patient groups in level of psychotic symptomatology or general attention across the two test sessions. Patients withdrawn from haloperidol showed significant decreases in recent verbal memory function, while at the same time demonstrating significant increases in remote verbal memory. We speculate that the observed pattern of results is consistent with medial temporal lobe dysfunction particularly prominent in the left hemisphere as patients become drug free, and provides support for the existence of state-dependent cognitive changes in schizophrenia.
采用被试内重复测量设计,在3周的时间间隔内,对两组DSM-III-R精神分裂症患者进行了近期和远期记忆以及一般注意力的神经心理学测量。一组患者(n = 12)在两次测试期间均维持使用氟哌啶醇,而另一组患者(n = 9)先在使用氟哌啶醇的情况下进行测试,3周后停药再次测试。研究期间患者未接受辅助性抗胆碱能药物治疗。在两次测试期间,两组患者在精神病症状水平或一般注意力方面均未观察到差异。停用氟哌啶醇的患者近期言语记忆功能显著下降,而同时远期言语记忆显著增加。我们推测,观察到的结果模式与内侧颞叶功能障碍一致,尤其是在患者停药时左半球尤为明显,并为精神分裂症中存在状态依赖性认知变化提供了支持。