未服药精神分裂症患者脑电gamma信号及抗精神病药物治疗随访研究  

The effect of antipsychotics on reduced oscillatory gamma-band responses in schizophrenic patients

作　　者：李惠[1] 王继军[1] 李春波[1] 苏亮[1] 施慎逊[1] 江开达[1] 肖泽萍[1] 

机构地区：[1]上海交通大学医学院附属精神卫生中心脑电影像室,上海200030

出　　处：《中华行为医学与脑科学杂志》2012年第9期800-802,共3页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家高技术研究发展计划项目（863计划2008AA02ZA12）;国家科技支撑计划项目（2009BA177805）;上海市精神卫生中心院级课题（2012-YJ-05）;上海市科学技术委员会基金项目（11410708800）

摘　　要：目的探讨未服药精神分裂症患者脑电gamma共振信号，同时研究抗精神病药物治疗对其特征影响情况。方法前瞻性对照研究纳入未服药精神分裂症患者，由治疗医师决定氯氮平治疗者26例，氯丙嗪治疗者30例；同时纳入正常对照18例。基线和8周随访时检测和分析40Hz短音链诱发的听觉稳态gamma信号，并与阳性和阴性症状量表（PANSS）评定结果作相关分析。结果未服药精神分裂症患者Fz和cz导联gamma频段功率[（5．08±1．48）μV2；（4．70±2．03）μV2]低于正常对照组[（6．91±1．64）μV2；（6．93±1．43）μV2]，差异均有统计学意义（P〈0．0001），且有gamma震荡位相一致性（ITC）比值[（0．14±0．04）；（0．13±0．04）]低于正常对照组[（0．18±0．06）；（0．17±0．06）]趋势，差异接近统计学意义（P=0．051；P=0．056）。治疗前后的gamma频段功率和ITC变化，差异均无统计学意义（P〉0．05）。结论精神分裂症患者的脑电gamma信号异常在治疗前就存在，抗精神病药物治疗对这一异常缺乏改善作用。Objective To explore gamma resonance signals in acute medication-free schizophrenics, and the effects of antipsychotics on gamma activity. Methods Schizophrenia patients （ n = 56） and normal controls （ n = 18 ） underwent auditory steady-state event-related potential testing and were evaluated of their psychopathic syn- dromes with the positive and negative syndrome scale（PANSS） before and after 8 weeks of medication with oral chlorpromazine or clozapine. Click trains varying in rate of stimulation 40 Hz were presented ; EEG-evoked power and intertrial phase synchronization were obtained in response to stimulation frequency. Results Schizophrenic patients showed reduced evoked power（Fz： （5.08 ± 1.48） ixV2 vs （6.91 ± 1.64） ixV2 ;Cz： （4.70 ±2.03） p.V2 vs （ 6.93 ± 1.43 ） txV2 ; P〈 0.01 ） and a tendency of reduction in phase synchronization （ Fz ： 0.14±0.04 vs 0.13 ±0.04, P = 0.051 ; Cz ： 0.18 ± 0.06 vs 0.17 ± 0.06, P= 0. 056） in response to 40 Hz stimulation. However significant correlations were not observed between oscillatory responses and clinical parameters in schizophrenic patients. There were no significant differences of gamma power and ITC in patients before and after chlorpromazine or clozapine administered. Conclusion Schizophrenia patients have deficits in the power and coherent of gamma oscillations, and can not be normalized by medication with antipsychotics.

关 键 词：精神分裂症 诱发电位 gamma共振 gamma功率 

分 类 号：R749.3[医药卫生—神经病学与精神病学]