Salisbury D F, Shenton M E, Sherwood A R, Fischer I A, Yurgelun-Todd D A, Tohen M, McCarley R W
Harvard Medical School, Department of Psychiatry, McLean Hospital, Belmont, Mass., USA.
Arch Gen Psychiatry. 1998 Feb;55(2):173-80. doi: 10.1001/archpsyc.55.2.173.
Schizophrenia is associated with central (sagittal) midline reductions of the P300 cognitive event-related potential and topographic asymmetry of P300, with reduced left temporal voltage. This P300 asymmetry is, in turn, linked to tissue volume asymmetry in the posterior superior temporal gyrus. However, it is unknown whether P300 asymmetry is specific to schizophrenia and whether central and lateral P300 abnormalities are due to chronic morbidity, neuroleptic medication, and/or hospitalization, or whether they are present at the onset of illness.
P300 was recorded in first-episode schizophrenia, first-episode affective psychosis, and control subjects (n = 14 per group). Subjects silently counted rare (15%) target tones (1.5 kHz) among trains of standard tones (1.0 kHz). Averages were constructed from brain responses to target tones.
Peak amplitude of P300 and integrated voltage over 300 to 400 milliseconds were significantly different between first-episode schizophrenics and controls over the posterior sagittal midline of the head. First-episode schizophrenics displayed smaller amplitudes over the left temporal lobe than first-episode affective psychotics and controls, but the groups showed no differences over the right temporal lobe.
Left-sided P300 abnormality in first-episode schizophrenia relative to first-episode affective psychosis and controls suggests that P300 asymmetry is specific to schizophrenic psychosis and present at initial hospitalization. This P300 asymmetry suggests left temporal lobe dysfunction at the onset of schizophrenia.
精神分裂症与P300认知事件相关电位的中央(矢状)中线降低以及P300的地形不对称有关,左颞叶电压降低。这种P300不对称反过来又与颞上回后部的组织体积不对称有关。然而,P300不对称是否是精神分裂症所特有的,以及中央和外侧P300异常是由于慢性发病、抗精神病药物治疗和/或住院,还是在疾病发作时就已存在,目前尚不清楚。
对首发精神分裂症患者、首发情感性精神病患者和对照组(每组n = 14)进行P300记录。受试者在标准音调(1.0 kHz)序列中默默计数罕见(15%)的目标音调(1.5 kHz)。对大脑对目标音调的反应进行平均。
首发精神分裂症患者与对照组在头部矢状后中线的P300峰值振幅以及300至400毫秒内的积分电压存在显著差异。首发精神分裂症患者左颞叶的振幅小于首发情感性精神病患者和对照组,但三组在右颞叶上无差异。
首发精神分裂症相对于首发情感性精神病和对照组的左侧P300异常表明,P300不对称是精神分裂症性精神病所特有的,且在初次住院时就已存在。这种P300不对称提示精神分裂症发作时左颞叶功能障碍。