精神分裂症和双相障碍的神经认知偏侧化比较

摘要

Objective To explore the differences of neurocognition between patients with schizophrenia and bipolar disorder. Methods 60 patients with schizophrenia (SZ group),62 patients with bipolar disorder (BD group)and 70 healthy controls (control group)were accessed with Edinburgh Handedness Inventory,as well as neurocognitive tests including Category Fluency Test (CFT),Line Bisection Test (LBT),Number Bisection Test (NBT),Groove Pegboard Test (GPT),Coin Rotation Test (CRT),Finger Tapping Test (FTT).Results There was significant difference in right hand mean deviation of LBT among the three groups (P <0.01 ).Pairwise comparison found rightward deviation in SZ group,moderate leftward deviation in control group and apparent leftward deviation in BD group.There were significant differences in right and left hand deviations of GPT among the three groups (P <0.01 ).Pairwise comparison indicated that left hand time in SZ group and BD group were significantly longer than that in control group (P <0.01).The right hand time was the longest in SZ group and the shortest in control group (P <0.05).Laterality index in BD group was significantly higher than that in SZ group and control group.There were significant differences in scores of CRT of right hand and left hand among the three groups (P <0.01).Pairwise comparison showed the worst CRT score of both hands in SZ group and the best CRT score of both hands in control group (P <0.01).There was significant difference in score of CFT among the three groups (P <0.01)and pairwise comparison indicated that score of CFT in control group was significantly better than that in SZ group and BD group.Conclusion There is a lateralization model in neurocognitive dysfunction in patients with schizophrenia and bipolar disorder.It is likely to be deficient lateralization in schizophrenia and excessive lateralization in bipolar disorder.%目的：探讨精神分裂症和双相障碍的神经认知功能差异。方法对60例精神分裂症患者（SZ 组）、62例双相障碍患者（BD 组）和70例正常对照（对照组）进行爱丁堡利手量表（Edinburgh handedness inventory）评估，以及范畴流畅性测验、线段等分测验（LBT）、数字等分测验、沟槽钉板测验（GPT）、硬币旋转测验（CRT）和手指敲击测验（FTT）。结果三组间 LBT 右手偏差百分数的差异有统计学意义（P ＜0．01），两两比较显示 SZ 组为右偏，对照组左偏，BD 组左偏更为明显。GPT 左、右两侧的三组组间比较差异均有统计学意义（P ＜0．01），两两比较显示左手时间 SZ 组和 BD 组均长于对照组（P ＜0．01），右手时间 SZ 组最长，HC 组最短（P ＜0．05）。BD 组的偏侧化指数大于 SZ 组和对照组。CRT 左、右手总体比较差异均有统计学意义（P ＜0．01），两两比较显示左、右手均为 SZ 组成绩最差，BD 组次之，对照组最好（P ＜0．01）。CFT 总体比较差异有统计学意义（P ＜0．01），两两比较显示 SZ 组和 BD 组均比对照组成绩差（P ＜0．05）。结论精神分裂症和双相障碍患者可能存在偏侧化的神经认知损害，精神分裂症可能为偏侧化不足，双相障碍可能为偏侧化过度。