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精神分裂症患者及其亲属中小脑和皮质感觉功能障碍的神经学体征。

Neurologic signs of cerebellar and cortical sensory dysfunction in schizophrenics and their relatives.

作者信息

Kinney D K, Yurgelun-Todd D A, Woods B T

机构信息

Laboratories for Psychiatric Research, McLean Hospital, Belmont, MA 02478, USA.

出版信息

Schizophr Res. 1999 Jan 11;35(2):99-104. doi: 10.1016/s0920-9964(98)00121-2.

Abstract

Previous research has found that both schizophrenics and their relatives have significantly elevated rates of clinical neurologic signs--including 'hard' signs screened to exclude artifacts. The present study examined whether hard signs that indicate relatively localized dysfunction in particular brain regions significantly distinguish schizophrenics and/or their non-schizophrenic relatives from psychiatrically normal controls and patients with other disorders. All patients were diagnosed with DSM-III or DSM-IIIR criteria, using information from structured interviews, supplemented by chart review and family informants. Subjects were administered clinical neurologic examinations by a neurologist blind to diagnosis. The proband sample, composed of 54 schizophrenic or schizoaffective subjects, had a significantly greater proportion of subjects with signs of cerebellar dysfunction than any of the comparison samples, which included: 44 control subjects, 24 patients with substance abuse, 37 patients with bipolar disorder, and 73 of the probands' non-schizophrenic parents and adult siblings. Proportions of both probands and their relatives with signs of dysfunction of sensory cortex were significantly higher than for other groups. Cerebellar and sensory cortical dysfunctions may distinguish different subgroups of schizophrenics and may tend to reflect, respectively, non-familial and familial neuropathological factors.

摘要

先前的研究发现,精神分裂症患者及其亲属出现临床神经学体征的比例显著升高,这些体征包括经过筛选以排除人为因素的“硬性”体征。本研究探讨了那些表明特定脑区存在相对局限性功能障碍的硬性体征,是否能显著区分精神分裂症患者和/或其非精神分裂症亲属与精神状态正常的对照组以及患有其他疾病的患者。所有患者均根据《精神疾病诊断与统计手册》第三版(DSM-III)或第三版修订本(DSM-IIIR)标准进行诊断,诊断信息来自结构化访谈,并辅以病历审查和家属提供的信息。由一位对诊断不知情的神经科医生对受试者进行临床神经学检查。先证者样本由54名精神分裂症或分裂情感性障碍患者组成,与其他对照样本相比,该样本中出现小脑功能障碍体征的受试者比例显著更高,这些对照样本包括:44名对照受试者、24名药物滥用患者、37名双相情感障碍患者以及73名先证者的非精神分裂症父母和成年兄弟姐妹。先证者及其亲属中出现感觉皮层功能障碍体征的比例均显著高于其他组。小脑和感觉皮层功能障碍可能区分精神分裂症的不同亚组,并且可能分别倾向于反映非家族性和家族性神经病理学因素。

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