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[精神分裂症易感性。I:神经心理学指标的家族性质]

[Vulnerability to schizophrenia. I: Familial nature of of neuropsychologic indicators].

作者信息

d'Amato T, Saoud M, Triboulet P, Bertaud J P, Dalery J

机构信息

Institut de Psychopathologie Cognitive et Neurobiologique, Université de Lyon 1.

出版信息

Encephale. 1998 Sep-Oct;24(5):442-8.

PMID:9850818
Abstract

The existence of a genetic background is now a well admitted notion in schizophrenia, but some individuals at genetic risk for that disease could never manifest it at a clinical level. However, several vulnerability models could help us to identify such individuals. According to them, when similar perturbations at a given test are observed both in clinically stable schizophrenics and their nonschizophrenic first degree relatives, this test could be qualify as an indicator of the vulnerability to schizophrenia. In literature, that seems the case for several neuropsychological tasks, exploring attentional abilities (degraded version of the Continuous Performance Task [DS-CPT], and Span Of Apprehension task [SOA]) and executive functions (Wisconsin Card Sorting Test [WCST]). Our study was undertaken to replicate literature data and to further explore the relationship between these three neuropsychological markers. For that purpose, performances at DS-CPT, SOA and WCST were assessed among 18 clinically stable schizophrenics, 18 of their biological full siblings and 15 unrelated control subjects matched with the two others groups for several socio-demographic factors. Comparisons were performed by non parametric analysis (Kruskal-Wallis one way ANOVA, and Mann-Whitney). Compared to controls, the siblings group performances were significantly impaired on the three tasks, while they did not statistically differ from the schizophrenic ones. No relationship was observed between the markers, except for the "d'" index at DS-CPT and the number of successfully performed categories at the WCST. Results from the sibling group suggested that the observed impaired neuropsychological performances may actually represent indicators of the genetic vulnerability to schizophrenia. Moreover, the generally admitted relationship between WCST poor performances and an impairment of the prefrontal cortex, lead us to hypothesize some role of this brain area in schizophrenia vulnerability.

摘要

遗传背景的存在如今在精神分裂症领域已是一个被广泛认可的概念,但一些有该疾病遗传风险的个体在临床层面可能永远不会表现出病症。然而,有几种易感性模型可以帮助我们识别这类个体。根据这些模型,当在临床症状稳定的精神分裂症患者及其非精神分裂症的一级亲属中观察到在特定测试中有相似的功能紊乱时,这个测试就可以被视作精神分裂症易感性的一个指标。在文献中,对于一些神经心理学任务而言似乎确实如此,这些任务探究注意力能力(连续操作测试的简化版[DS-CPT]和领会广度任务[SOA])以及执行功能(威斯康星卡片分类测试[WCST])。我们开展这项研究是为了复制文献数据,并进一步探究这三种神经心理学指标之间的关系。为此,我们对18名临床症状稳定的精神分裂症患者、18名他们的亲生同胞手足以及15名在几个社会人口统计学因素上与其他两组匹配的无血缘关系的对照受试者进行了DS-CPT、SOA和WCST测试。通过非参数分析(Kruskal-Wallis单因素方差分析和Mann-Whitney检验)进行比较。与对照组相比,同胞手足组在这三项任务上的表现明显受损,而与精神分裂症患者组相比在统计学上没有差异。除了DS-CPT的“d’”指数和WCST中成功完成的分类数之间存在关系外,在这些指标之间未观察到其他关系。同胞手足组的结果表明,观察到的神经心理学表现受损实际上可能代表了精神分裂症的遗传易感性指标。此外,普遍认可的WCST表现不佳与前额叶皮质受损之间的关系,使我们推测该脑区在精神分裂症易感性中发挥了某种作用。

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