事件相关电位对精神病临床高危人群临床结局的预测作用  

Event-related potentials as predictors of clinical outcomes in patients with clinical high risk of psychosis

作　　者：吴桂森 甘冉飘 唐晓晨 张天宏[1] Wu Guisen;Gan Ranpiao;Tang Xiaochen;Zhang Tianhong(Department of Electroencephalography and Imaging,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China)

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研究室,200030

出　　处：《中华行为医学与脑科学杂志》2020年第4期379-384,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金项目(81671329);上海交通大学“转化医学交叉研究基金”重点项目(ZH2018ZDB03)。

摘　　要：大部分精神分裂症患者在首次发作前存在临床高危状态(clinical high risk,CHR)的时期。早期识别CHR并实施药物或心理干预可能减少精神病的转化。找到预测精神病发作的生物标志物并提高对CHR预后判断的准确性,将有助于采取更积极的干预措施。事件相关电位(event-related potential,ERP)作为一种检测快捷、耗费低廉的神经电生理学检测,可以反映认知过程中的感觉、前注意加工、注意分配等进程,并可能成为预测CHR患者临床结局的客观指标。对关于CHR人群的不同ERP成分研究,及其作为CHR临床结局的预测指标的表现进行文献分析。结果显示P300和失匹配负波(MMN)波幅降低作为检测的异常指标显得比其他ERP成分异常更为可靠,这可能表明ERP不同成分的异常反映了疾病进程的不同阶段。但ERP异常作为CHR患者的生理学指标较缺乏特异性。未来结合不同ERP成分或是ERP成分结合临床症状等的算法分析,或许可以使检测更具有特异性。Most patients with schizophrenia have experienced a period called clinical high risk(CHR)preceding the first episode of psychosis.Early identification of CHR and timely medication or psychological intervention may reduce conversion to psychosis.By exploring biomarkers that predict the onset of psychosis and improving the accuracy of predicting the prognosis of CHR state,it is possible to take a more active intervention measure.As a fast and economical neurophysiological test,event-related potential(ERP)may reflect the perception process,pre-attention process,and attention distribution of the cognitive processes.And it holds promise for becoming objective indices in predicting the clinical outcomes of the CHR patients.This paper reviews the current studies on different ERP components in the CHR population and their performance as predictors of clinical outcomes.The results show that among ERP abnormalities,P300 and MMN amplitude reductions appear to be more reliable than others,which may indicate that distinct components reflect different stages of the disease.However,as a physiological index in the CHR group,aberrant ERP lacks certain specificity.The algorithm analysis combining different ERP components or combining components with symptoms may make the test more specific in the future.

关 键 词：临床高危状态 精神病 事件相关电位 临床结局 

分 类 号：R74[医药卫生—神经病学与精神病学]