Parellada E, Catafau A M, Bernardo M, Lomeña F, Catarineu S, González-Monclús E
Department of Psychiatry, IDIBAPS (Institut D'Investigacions Biomèdiques August Pi i Sunyer), Hospital Clínic, Universitat de Barcelona, Spain.
Biol Psychiatry. 1998 Oct 15;44(8):787-90. doi: 10.1016/s0006-3223(98)00057-2.
Functional neuroimaging findings of "hypofrontality" in schizophrenic patients is still controversial, due to the heterogeneity of methods and patient samples. This study tries to prevent some of these concerns by studying neuroleptic-naive (NN) and neuroleptic-free (NF) young female patients both in resting conditions and during a frontal cognitive activation task.
Regional cerebral blood flow (rCBF) was studied at rest and during the Wisconsin Card Sorting Test (WCST) in 25 young acute unmedicated schizophrenic female patients (14 NN and 11 NF) and 15 female controls, using single photon emission computed tomography.
The schizophrenic and control groups did not differ in rCBF during the baseline condition, but the schizophrenic group failed to activate the frontal lobe during the WCST condition. In addition, the left anterior temporal rCBF at rest correlated with the Scale for the Assessment of Positive Symptoms total score.
The results suggest that hypofrontality in young acute unmedicated schizophrenic patients is a result of an inability to activate frontal regions during cognition, rather than a baseline decrease in frontal activity. Furthermore, positive symptoms seem to be associated with left temporal cortex activity.
由于方法和患者样本的异质性，精神分裂症患者“前额叶功能低下”的功能性神经影像学研究结果仍存在争议。本研究试图通过研究未使用过抗精神病药物的（NN）和未服用抗精神病药物的（NF）年轻女性患者在静息状态和额叶认知激活任务期间的情况，来避免其中一些问题。
使用单光子发射计算机断层扫描，对25名未接受药物治疗的急性年轻精神分裂症女性患者（14名NN和11名NF）和15名女性对照者在静息状态和威斯康星卡片分类测验（WCST）期间的局部脑血流量（rCBF）进行研究。
在基线状态下，精神分裂症组和对照组的rCBF没有差异，但在WCST状态下，精神分裂症组未能激活额叶。此外，静息状态下左侧颞叶前部的rCBF与阳性症状评定量表总分相关。
结果表明，未接受药物治疗的急性年轻精神分裂症患者的前额叶功能低下是认知过程中无法激活额叶区域的结果，而不是额叶活动的基线下降。此外，阳性症状似乎与左侧颞叶皮质活动有关。
