精神分裂症感觉门控电位P50和惊跳反射弱刺激抑制的相关性  

Correlation between P50 auditory sensory gating and prepulse inhibition in patients with schizophrenia

作　　者：石晶[1] 王志仁[1] 谭云龙[1] 谭淑平[1] 张进国[1] 刘小蕾[2] 周晨辉[2] 安会梅[1] 杨甫德[1] 周东丰[3] 

机构地区：[1]北京回龙观医院,北京100096 [2]内蒙古医科大学,呼和浩特010059 [3]北京大学第六医院,北京大学精神卫生研究所,卫生部精神卫生学重点实验室(北京大学),北京100191

出　　处：《中国心理卫生杂志》2016年第5期345-351,共7页Chinese Mental Health Journal

基　　金：国家自然科学基金项目(81000579);首都医学发生科研基金(2009-3148);北京市优秀人才培养资助(2013D003034000020);北京市医院管理局临床医学发展专项(ZYLX201409)

摘　　要：目的:探讨精神分裂症患者感觉门控电位P50和惊跳反射弱刺激抑制(PPI)的特征以及两者的相关性。方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)的精神分裂症患者78例,正常对照90例,使用阳性和阴性症状量表(PANSS)评定精神分裂症患者的临床精神病理症状;使用脑电生理记录仪,采用听觉条件(S1)-测试(S2)刺激范式进行P50检测;使用SR-HLAB惊跳反射监控系统测查听觉惊跳反射。结果:精神分裂症组的S1波幅低于对照组[(2.9±1.7)μV vs.(3.7±2.0)μV,P<0.05];S2波幅高于对照组[(2.0±1.2)μV vs.(1.4±1.5)μV,P<0.001];P50抑制率比值(S2/S1)精神分裂症组高于对照组[(0.8±0.5)vs.(0.4±0.4),P<0.001],P50抑制率差值(S1-S2)低于对照组[(0.9±1.7)vs.(2.3±1.8),P<0.001]。精神分裂症组的惊跳反射的波幅低于对照组[(1037.5±1048.6)ms vs.(1367.7±952.3)ms,P<0.001],习惯化百分比亦低于对照组[(33.9±20.8)%vs.(48.8±34.7)%,P=0.002];精神分裂症组的PPI60和PPI120均低于对照组[(24.1±9.1)%vs.(29.8±11.5)%,P=0.020;(31.2±10.1)%vs.(42.6±15.4)%,P<0.001]。在精神分裂症组中,P50各项分析指标与PPI各项分析指标间的相关性无统计学意义(P>0.05),P50与PPI各项分析指标与PANSS总分、PANSS阳性症状总分、PANSS阴性症状总分间的相关性无统计学意义(P>0.05);在对照组中,惊跳反射的波幅与s1波幅与s2波幅呈正相关(r=0.28、0.27,均P<0.05)。结论:精神分裂症患者可能存在感觉门控的缺陷,P50和PPI缺陷与临床精神病理症状的严重程度可能无关,反映感觉门控的两种测量模式P50和PPI间可能无相关性,二者可能相互独立。Objective: To investigate the correlation between P50 auditory sensory gating( P50) and prepulse inhibition( PPI) and the characteristic of them in patients with schizophrenia. Methods: Seventy-eight patients with schizophrenia and ninety normal healthy volunteers were recruited. All patients met the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition( DSM-IV) criteria for schizophrenia. The symptoms were assessed with the Positive and Negative Syndrome Scale( PANSS). P50 was measured using the conditioning / testing paradigm presented with auditory double clicks stimuli. Using SR-HLAB monitoring system to detect the auditory startle reflex. Results: Patients had a significant lower P50- S1 amplitude [( 2. 9 ± 1. 7) μV vs.( 3. 7 ± 2. 0) μV,P = 0. 017]and P50 suppression difference( S1- S2) [( 0. 9 ± 1. 7) vs.( 2. 3 ± 1. 8),P < 0. 01]. P50- S2 amplitude [( 2. 0 ±1. 2) μV vs.( 1. 4 ± 1. 5) μV,P < 0. 001] and P50 suppression ratio scores( S2 / S1) [( 0. 8 ± 0. 5) vs.( 0. 4 ± 0. 4),P < 0. 001] were significant higher in patients than in the controls. Compared to the controls,patients had significant lower PPI60 [( 24. 1 ± 9. 1) % vs.( 29. 8 ± 11. 5) %, P = 0. 020 ] and PPI120 [( 31. 2 ± 10. 1) % vs.( 42. 6 ±15. 4) %,P < 0. 001 ] as well as the amplitude of auditory startle reflex [( 1037. 5 ± 1048. 6) ms vs.( 1367. 7 ±952. 3) ms,P < 0. 001 ] and habituation% [( 33. 9 ± 20. 8) % vs.( 48. 8 ± 34. 7) %,P = 0. 002]. In patients,there was no a correlation between P50 and PPI( P > 0. 05). In the controls, the amplitude of auditory startle reflex showed a weak positive correlation with P50- S1 amplitude and P50- S2 amplitude( r = 0. 275,P = 0. 009 and r =0. 265,P = 0. 012 respectively). The bivariate correlation between the indicators of P50 or PPI and PANSS-total,PANSS-positive,PANSS-negative symptoms was not statistically significant( P > 0. 05). Conclusion: Patients with schizophrenia may present the deficits of the sensory gating. The deficits of sensory gating in schizophrenic patie

关 键 词：精神分裂症 感觉门控 P50诱发电位 弱刺激抑制 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R749.044[医药卫生—临床医学]