首发伴听幻觉偏执型精神分裂症加工音阶错觉的神经生理机制
发布时间：2019-03-02 11:07
【摘要】：背景 精神分裂症是一种高致残性疾病,其终身患病率为0.7%,我国现有患者780万,其病因不明,机制不清,预后不良,社会影响巨大；进一步了解其病因、病理、改善预后等具有重大的科研价值和社会意义。听幻觉是精神分裂症的核心症状之一,与患者疾病的严重程度及预后密切相关,因此对听幻觉机制的研究是本领域的重要课题。听错觉与听幻觉有着密切联系,它们可能有着共同的加工脑区,因此对听错觉的皮层加工机制的研究能部分揭示听幻觉的皮层加工机制。 目的 研究精神分裂症听错觉状态下皮层加工的特征及与临床症状的关联。 方法 1.首先我们在29名右利手正常健康人中测试了Deutsch音阶错觉(Deutsch octave illusion)的加工模型,报告在左侧听到高音者归为RL (reporting left)组,报告在右侧听到高音者归为RR (reporting right)组。然后选取首发伴听幻觉偏执型精神分裂症患者23名,从上述29名被试中选取匹配的健康对照被试23名。 2.以Positive and Negative Syndrome Scale (PANSS)评定精神分裂症患者症状严重程度。 3.以Deutsch音阶错觉的刺激范式对上述被试进行静音、错觉的normal和reversed sequences的实验,并记录其脑电。 4.分析EEG theta功率值/任务相关功率值和相干性/任务相关相干性,并采用重复测量方差分析的方法比较各组、各状态及不同皮层区域间的差异。 结果 1.在正常被试中,在normal和reversed sequences状态刺激后,RL组和RR组被试在任务相关功率值上均表现出右侧皮层高于左侧；而RR组被试右侧额中-颞半球内任务相关相干系数高于RL组被试。 2.在分裂症被试中,normal和reversed sequences状态下,亦存在听错觉的右侧加工优势,但分裂症患者双侧的任务相关功率值显著低于健康对照组；而双侧额中-颞半球内任务相关相干系数高于健康对照组。 3.分裂症患者右侧额中-颞区域任务相关功率值与PANSS听幻觉分值存在负相关,而右侧额中-颞区域半球内任务相关相干系数与PANSS听幻觉分值存在正相关。 结论 1.右利手人群中,音阶错觉片段能激起听觉加工相关区域额中叶和颞叶的活动。 2.右利手人群音阶错觉加工过程中,听觉优势(ear preference)与不同的额中-颞连结通路有关。 3.首发伴听幻觉的精神分裂症患者在听错觉加工中,存在额中-颞区域低激活、高同步化的现象。 4.首发伴听幻觉的精神分裂症患者在外源性错觉信息加工中存在皮层整合功能的障碍,包括自我监控机制、抑制机制以及代偿机制的作用。 5.首发伴听幻觉的精神分裂症患者在错觉加工中,额中-颞区域低激活、高同步化的现象与症状的严重程度有关。 总之,音阶错觉的加工能激起额中、颞区域的活动,其听觉优势与不同的额中-颞连结通路有关；精神分裂症患者在听错觉加工中,存在额中-颞区域低激活、高同步化的现象,反映了皮层整合功能的障碍,并与症状的严重程度有关。
[Abstract]:background Schizophrenia is a high-disabling disease with a lifetime prevalence of 0.7%. In our country, 77.8 million people have an unknown etiology, unclear mechanism, poor prognosis and great social impact. It is of great scientific research value and social meaning to improve the prognosis and so on. The auditory hallucination is one of the core symptoms of schizophrenia and is closely related to the severity and prognosis of the patient's disease, so the study of the auditory hallucination mechanism is an important lesson in this field. The auditory illusion is closely related to the auditory hallucinations, and they may have a common processing brain area, so the study of the cortical processing mechanism of the auditory illusion can partially reveal the auditory hallucinations cortex processing machine. System. Objective To study the characteristics and clinical significance of subcortical processing in the auditory illusion of schizophrenia. symptoms Methods 1. First of all, we tested the processing model of the Deutsch's scale delusion in the normal healthy people of the 29 right hand healthy people. The report reported on the left to the RL (reporting left) group on the left, and the report on the right as RR (reporti Ng right). Then,23 of the first-episode paranoid schizophrenia patients were selected and matched from the above-mentioned 29 subjects. 23 healthy control subjects.2. Positive and Negative Syndrome Scale (PANSS) The severity of the patient's symptoms.3. The above-mentioned subjects were mute, delusion normal, and revered sequen with the stimulation paradigm of the illusion of the Deutsch scale. The EEG theta power value/ task-related power value and the coherence/ task-related coherence were analyzed, and the method of repeated measurement of variance was used to compare the groups. each Results 1. In normal trial, the RL group and RR group were tested at the task-related power values to show that the right cortex was higher than the left; while the RR group was tested on the right-hand side- 2. The task-related coherence coefficient in the semi-sphere is higher than that of the RL group.2. In the normal and the normal conditions, the right processing advantage of the auditory illusion is also present, but the two-sided task-related power value of the patient is significantly lower than that of the healthy control group; and the bilateral amount The correlation coefficient of the task-related power in the middle-lower hemisphere was higher than that of the healthy control group.3. The related power value of the task-related power in the right frontal area of the patient was negatively correlated with the auditory hallucination score of the PANSS, while in the right frontal area, there was a negative correlation with the auditory hallucination score of the PANSS. the phase of a retreat The correlation coefficient was positively correlated with the auditory hallucination score of PANSS. An activity in the middle and the middle of an auditory processing-related area. (ear preference) is associated with a different amount of the-link path.3. The first episode with the mental division of auditory hallucinations. In the process of auditory delusions, the patients with laceration have low activation and high synchronization in the frontal-low region.4. The first episode of schizophrenia with auditory hallucinations is stored in the information processing of exogenous illusion. The disorder of the whole function of the cortex, including the mechanism of self-monitoring, the mechanism of inhibition and the role of the compensatory mechanism.5. The first episode of schizophrenia with auditory hallucinations. In the process of delusion, the phenomenon of low activation and high synchronization in the frontal-middle region is related to the severity of the symptoms. In that case of schizophrenia, in the proces of auditory delusions, there is an in-and-middle area.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R749.3
本文编号：2432990
[Abstract]:background Schizophrenia is a high-disabling disease with a lifetime prevalence of 0.7%. In our country, 77.8 million people have an unknown etiology, unclear mechanism, poor prognosis and great social impact. It is of great scientific research value and social meaning to improve the prognosis and so on. The auditory hallucination is one of the core symptoms of schizophrenia and is closely related to the severity and prognosis of the patient's disease, so the study of the auditory hallucination mechanism is an important lesson in this field. The auditory illusion is closely related to the auditory hallucinations, and they may have a common processing brain area, so the study of the cortical processing mechanism of the auditory illusion can partially reveal the auditory hallucinations cortex processing machine. System. Objective To study the characteristics and clinical significance of subcortical processing in the auditory illusion of schizophrenia. symptoms Methods 1. First of all, we tested the processing model of the Deutsch's scale delusion in the normal healthy people of the 29 right hand healthy people. The report reported on the left to the RL (reporting left) group on the left, and the report on the right as RR (reporti Ng right). Then,23 of the first-episode paranoid schizophrenia patients were selected and matched from the above-mentioned 29 subjects. 23 healthy control subjects.2. Positive and Negative Syndrome Scale (PANSS) The severity of the patient's symptoms.3. The above-mentioned subjects were mute, delusion normal, and revered sequen with the stimulation paradigm of the illusion of the Deutsch scale. The EEG theta power value/ task-related power value and the coherence/ task-related coherence were analyzed, and the method of repeated measurement of variance was used to compare the groups. each Results 1. In normal trial, the RL group and RR group were tested at the task-related power values to show that the right cortex was higher than the left; while the RR group was tested on the right-hand side- 2. The task-related coherence coefficient in the semi-sphere is higher than that of the RL group.2. In the normal and the normal conditions, the right processing advantage of the auditory illusion is also present, but the two-sided task-related power value of the patient is significantly lower than that of the healthy control group; and the bilateral amount The correlation coefficient of the task-related power in the middle-lower hemisphere was higher than that of the healthy control group.3. The related power value of the task-related power in the right frontal area of the patient was negatively correlated with the auditory hallucination score of the PANSS, while in the right frontal area, there was a negative correlation with the auditory hallucination score of the PANSS. the phase of a retreat The correlation coefficient was positively correlated with the auditory hallucination score of PANSS. An activity in the middle and the middle of an auditory processing-related area. (ear preference) is associated with a different amount of the-link path.3. The first episode with the mental division of auditory hallucinations. In the process of auditory delusions, the patients with laceration have low activation and high synchronization in the frontal-low region.4. The first episode of schizophrenia with auditory hallucinations is stored in the information processing of exogenous illusion. The disorder of the whole function of the cortex, including the mechanism of self-monitoring, the mechanism of inhibition and the role of the compensatory mechanism.5. The first episode of schizophrenia with auditory hallucinations. In the process of delusion, the phenomenon of low activation and high synchronization in the frontal-middle region is related to the severity of the symptoms. In that case of schizophrenia, in the proces of auditory delusions, there is an in-and-middle area.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R749.3
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相关期刊论文 前1条
1 陈昌惠,沈渔笛,张维熙,李淑然,黄悦勤,王金荣,王德平,涂建,宁佐喜,付力牧,纪丽萍,刘志广,吴化民,罗开林,翟书涛,严和獯,孟国荣;中国七个地区精神分裂症流行病学调查[J];中华精神科杂志;1998年02期
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