首发精神分裂症与双相障碍Ⅰ型患者失匹配负波的对照研究  

A comparative study about mismatch negativity between patients with schizophrenia and bipolar Ⅰ disorder

作　　者：李喆[1] 邓伟[1] 王强[1] 李名立[1] 李寅飞[1] 刘祥[1] 郑重[2] 李涛[1] 

机构地区：[1]四川大学华西医院心理卫生中心,四川成都610041 [2]四川大学华西医院神经生物检测中心

出　　处：《精神医学杂志》2015年第1期1-5,共5页Journal of Psychiatry

基　　金：国家自然科学基金项目(编号:81130024);科技部"十二五"支撑计划项目(编号:2012BAI01B06);教育部博士点基金项目(编号:20110181110014);四川省卫生厅课题(编号:130039)

摘　　要：目的探讨首发精神分裂症患者与伴精神症状史的双相I型患者的失匹配负波(MMN)及其与临床特征的相关性。方法比较45例首发精神分裂症患者(精神分裂症组),55例伴精神症状史的双相I型患者(双相障碍组)以及50例正常对照(对照组)的MMN;阳性和阴性综合征量表(PANSS)评估精神分裂症组症状,汉密尔顿抑郁量表(HAMD)及杨氏躁狂量表(YMRS)分别评估双相障碍组抑郁发作和躁狂发作症状,大体功能评定量表(GAF)评定三组总体功能水平。结果 (1)三组GAF评分比较差异有统计学意义(P<0.05)。(2)精神分裂症组和双相障碍组较对照组MMN潜伏期延长(P<0.01),双相障碍组MMN波幅降低(P<0.01)。(3)精神分裂症组MMN波幅与病程、PANSS总分呈负相关(P<0.05);双相障碍组MMN潜伏期与发作次数、疾病严重程度呈正相关(P<0.05),MMN波幅与发作次数、疾病严重程度呈负相关(P<0.05)。结论首发精神分裂症与伴精神症状史的双相I型患者均有MMN异常,二者可能存在共同神经病理机制;MMN潜伏期和波幅可能分别是精神分裂症的素质性和状态性标记,而MMN异常可能是双相I型的状态性标记。Objective To investigate the mismatch negativity （MMN）in first episode schizophrenia and bipolar I disorder with psychotic history and to explore the relationship between MMN and clinical characteristics.Methods 45 patients with first episode schizophrenia （FES）,55 patients with bipolar I disorder （BPD）with psychotic history and 50 healthy controls （HC） were included in this study.The clinical status of patients with schizophrenia and bipolar I disorder were assessed by using PANSS and HAMD,YMRS respectively.All subjects in 3 groups were assessed with GAF to evaluate their overall functioning status.Results （1）There was significant difference in score of GAF among the 3 groups （P 〈0.05）.（2）Compared with HC group,both FES group and BPD group showed significantly delayed MMN latency （P 〈0.01 ）,and only BPD group showed significantly decreased MMN amplitude （P 〈0.01）.（3）MMN amplitude in FES group was significantly negatively correlated with course of disease and total score of PANSS （P 〈0.05）.MMN latency in BPD group was significantly positively correlated with onset frequency and severity （P 〈0.05）,and MMN amplitude in BPD group was significantly negatively correlated with onset frequency and severity （P 〈0.05）.Conclusion Abnormality of MMN exist in patients with first onset schizophrenia and bipolar I disorder with psychotic history,which throw light on the overlapping neuropathology mechanisms in both diseases.MMN latency and amplitude may represent the trait marker and state marker of schizophrenia respectively.However,MMN abnormality may only be state marker of Bipolar I disorder.

关 键 词：精神分裂症 双相障碍 失匹配负波 

分 类 号：R749.3[医药卫生—神经病学与精神病学]