精神分裂症暴力行为者感觉门控P50与威斯康星分类测试的相关性

摘要

目的 分析精神分裂症暴力行为者的感觉门控与执行功能的变化及其相关性.方法 应用美国EGI 256导联高密度脑电仪器对2008年2月至2009年3月北京市安康医院35例暴力行为精神分裂症患者(暴力组)和32名健康对照者(正常组)测量感觉门控P50变化,同时应用威斯康星卡片分类测试(WCST)测量其执行功能,分析其相关性,并随访3个月的变化.结果 (1)与正常组相比,暴力组在基线时和治疗3个月时S2-P50波幅大(P＜0.05)[基线时:暴力组(1.8±1.1)μV,正常组(0.9±0.6)μV;治疗3个月时:暴力组(1.9±1.6)μV],S2/S1比值大,S1-S2差值及100×(1-S2/S1)值小(均P＜0.05).(2)基线时和治疗3个月时,两组均在学习到学会(L-1)差异无统计学意义[基线时(t=0.585,P=-0.561),治疗3个月时(t=-0.021,P=0.983)],其余指标差异有统计学意义(P＜0.05).(3)两组S2/S1、S1-S2与WCST指标在基线时和治疗3个月时均无相关性(P＞0.05).结论 精神分裂症暴力行为患者在未用药时及治疗3个月时均存在感觉门控和执行功能的损害.感觉门控和执行功能二者无相关性,提示其可能从不同方面反映精神分裂症患者的大脑功能变化.%Objective To analyze the variations of sensory gating and executive functions in schizophrenics with violent behaviors, and the relationship between sensory gating and executive functions.Methods Thirty-five schizophrenics with violent behaviors (Group V ) and 32 healthy control persons (Group C) were recorded by P50 with EGI 256 high density EEG. They were also examined by Wisconsin card sorting test (WCST) and followed up for 3 months. The relationship of sensory gating P50 and WCST was evaluated by Person' s analysis. Results ( 1 ) Compared with Group C, Group V showed a higher amplitude of S2-P50 [baseline: ( 1.8 ± 1. 1 ) vs (0. 9 ± 0.6 ) μV; 3-month treatment: ( 1.9 ± 1. 6)μ V].There was a higher S2/S1 ratio, a lower S1-S2 difference and 100 × ( 1-S2/S1 ) at baseline and after 3 months (P ＜0. 05 ) [baseline: S2/S1, S1-S2 and 100 × (1-S2/S1) in both groups respectively [(89 ±49) vs (42 ± 25), (0. 7 ± 2. 5) vs ( 1.4 ± 1.2), ( 11 ± 49) vs (58 ± 25); 3 months treatment: ( 170 ± 277,- 0. 0 ± 1.8, - 70 ± 277)]; (2) At baseline and after a 3-month treatment, two groups had no difference in learning [baseline (t = - 0. 585, P = 0. 561 ), 3 months ( t = - 0. 021, P = 0. 983 )] ( P ＞ 0. 05 ) and there were significant differences in other indices ( P ＜ 0. 05 ); ( 3 ) No relationship was found between S2/S1 ratio, S1-S2 and WCST in two groups at baseline and after a 3-month treatment by Person's analysis.Conclusions The schizophrenics with violent behaviors have sensory gating deficits and abnormal executive functions before and after treatment. Sensory gating and executive functions may reflect different brain functions in schizophrenics.