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氯氮平对精神分裂症听觉事件相关电位的影响。

Effects of clozapine on auditory event-related potentials in schizophrenia.

作者信息

Umbricht D, Javitt D, Novak G, Bates J, Pollack S, Lieberman J, Kane J

机构信息

Research Department, Psychiatric University Hospital, Zurich, Switzerland.

出版信息

Biol Psychiatry. 1998 Oct 15;44(8):716-25. doi: 10.1016/s0006-3223(97)00524-6.

Abstract

BACKGROUND

Schizophrenia is associated with cognitive deficits that are an intrinsic component of the disorder. Clozapine is an atypical antipsychotic that is superior to typical agents in the treatment of positive symptoms. The degree to which clozapine ameliorates cognitive deficits, however, is still controversial. Mismatch negativity (MMN), N200 (N2), and P300 (P3) are cognitive event-related potentials (ERPs) that index preattentive (MMN) and attention-dependent information processing (N2, P3) and provide a measure of cognitive deficits associated with schizophrenia. In schizophrenic patients deficient generation of MMN, N2, and P3 has been observed, suggesting impairments of discrete stages of information processing.

METHODS

This study investigates the effects of clozapine treatment on MMN, N2, and P3 generation. Patients were recruited from a haloperidol-controlled, double-blind treatment study of clozapine in chronic schizophrenia. ERPs were obtained at the beginning of the study and after 9 weeks (4 patients) and 16 weeks (13 patients) of treatment.

RESULTS

Clozapine treatment was associated with a significant increase of P3 amplitude, which was not observed in the haloperidol group; however, clozapine treatment did not affect deficits in MMN and N2.

CONCLUSIONS

These findings suggest that clozapine--in contrast to conventional antipsychotics--improves electrophysiological measures of attention-dependent information processing, but does not ameliorate preattentive deficits.

摘要

背景

精神分裂症与认知缺陷相关,认知缺陷是该疾病的一个内在组成部分。氯氮平是一种非典型抗精神病药物,在治疗阳性症状方面优于典型药物。然而,氯氮平改善认知缺陷的程度仍存在争议。失配负波(MMN)、N200(N2)和P300(P3)是认知事件相关电位(ERP),分别指示前注意(MMN)和依赖注意的信息处理(N2、P3),并提供一种衡量与精神分裂症相关的认知缺陷的方法。在精神分裂症患者中,已观察到MMN、N2和P3的产生不足,提示信息处理的离散阶段存在损害。

方法

本研究调查氯氮平治疗对MMN、N2和P3产生的影响。患者从一项氯氮平治疗慢性精神分裂症的氟哌啶醇对照双盲治疗研究中招募。在研究开始时以及治疗9周(4例患者)和16周(13例患者)后获取ERP。

结果

氯氮平治疗与P3波幅显著增加相关,氟哌啶醇组未观察到这种情况;然而,氯氮平治疗并未影响MMN和N2的缺陷。

结论

这些发现表明,与传统抗精神病药物相比,氯氮平可改善依赖注意的信息处理的电生理指标,但不能改善前注意缺陷。

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