儿童精神分裂症前脉冲抑制特征及三年随访  

Characteristics of prepulse inhibition and three-year follow up in children with schizophrenia

作　　者：张郦[1] 张云飞[2] 刘占文 李婷 季海峰[1] 刘丽[1] 薛连学 陈兴时[3] ZHANG Li;ZHANG Yunfei;LIU Zhanwen;LI Ting;JI Haifeng;LIU Li;XUE Lianxue;CHEN Xingshi(Shanghai Changning Mental Health Center,Shanghai 200335,China)

机构地区：[1]上海市长宁区精神卫生中心精神科,上海200335 [2]上海市嘉定区精神卫生中心精神科六病区 [3]上海交通大学附属精神卫生中心神经生理室(国家精神疾病医学中心)

出　　处：《中国神经精神疾病杂志》2023年第5期269-273,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：上海市长宁区科技计划项目(编号:CNKW2022Y40)。

摘　　要：目的初步探讨儿童精神分裂症前脉冲抑制(prepulse inhibition,PPI)特征,并随访其变化。方法纳入56例儿童精神分裂症患者和38名健康儿童,应用事件相关脑电仪,采用单独强刺激和弱刺激+强刺激范式,进行PPI检测。患儿组于治疗后第1年、第2年和第3年进行PPI随访。结果基线时,在Cz点,患儿组比对照组单独强刺激的惊跳反射潜伏期延长[(97.00±13.02)ms vs.(86.02±11.10)ms,P<0.01],患儿组比对照组弱刺激+强刺激的惊跳反射潜伏期延长[(97.01±20.02)ms vs.(84.01±17.02)ms,P<0.01]、波幅增高[(47.01±21.00)μV vs.(39.00±12.01)μV,P<0.01],患儿组PPI比值低于对照组(43.02%±37.21%vs.66.00%±32.01%,P<0.01)。未发现患儿组PPI各指标与PANSS量表总分、各因子分有统计学相关性(P>0.05)。患儿组在治疗后的第1年、第2年和第3年进行PPI检测,Cz点惊跳反射波幅、PPI比值与治疗前比较差异无统计学意义(P>0.05)。结论儿童精神分裂症患者PPI存在异常,随访提示PPI变异可能是儿童精神分裂症患者的属性标志,此初步结论有待于临床中进一步证实。Objective Preliminary study on the characteristics of prepulse inhibition(PPI)in children with schizophrenia and follow-up of its changes.Method By utilizing an event related electroencephalograph from a German company,PPI was performed on 56 children with schizophrenia and 38 healthy children using a single strong stimulus and weak stimulus+strong stimulus paradigm.The child with schizophrenia group underwent PPI follow-up in the first,second,and third years of treatment.Result At baseline,the latency of the startle reflex at point Cz was longer in the children with schizophrenia group than in the control group(97.00±13.02 ms vs.86.02±11.10 ms,P<0.05).The children with schizophrenia had a longer latency(97.01±20.02 ms vs.84.01±17.02 ms,P<0.05)and higher amplitude(47.01±21.00μV vs.39.00±12.01μV,P<0.05)of startle reflex under weak and strong stimuli compared to the control group.The PPI inhibition rate was lower in the child with schizophrenia group than in the control group(43.02%±37.21%vs.66.00%±32.01%,P<0.05).No significant correlation was found between the PPI indicators and the PANSS scores in the child with schizophrenia group(P>0.05).When PPI tests were performed in the first,second and third years after treatment,no significant differences were found in the wave amplitude of the startle reflex and the PPI ratio of weak stimulation+strong stimulation in the Cz-point brain region compared to the pre-treatment period(P>0.05).Conclusion Children with schizophrenia have abnormal PPI and PPI variation may be an attribute marker for children with schizophrenia.This preliminary conclusion needs to be verified in further clinical studies.

关 键 词：精神分裂症 儿童 感觉门控 前脉冲抑制 生物学标记 随访 潜伏期 波幅 

分 类 号：R749.3[医药卫生—神经病学与精神病学]