摘要
目的比较精神分裂症和抑郁症患者大脑皮质抑制异常并探索其与临床症状的相关性。方法招募35例首发精神分裂症患者、41例抑郁症患者(21例首发抑郁症、20例复发抑郁症)和35名健康对照。使用经颅磁刺激脉冲进行大脑皮质抑制和兴奋指标检测。使用阳性与阴性精神症状评定量表评估精神分裂症患者的症状,17项汉密尔顿抑郁量表和汉密尔顿焦虑量表评估抑郁症患者的症状。以年龄、性别和是否用药为协变量,使用协方差分析或广义线性模型对大脑皮质抑制和兴奋指标进行组间比较,并分析其与临床症状的相关性。结果首发精神分裂症组皮质静息期长于对照组和抑郁症组[(92.08±35.43)ms vs.(70.27±22.12)ms vs.(70.81±29.29)ms,P<0.05]。将抑郁症分为首发抑郁症和复发抑郁症亚组,首发抑郁症组的短间隔皮质抑制弱于复发抑郁症组和对照组(0.76±0.44 vs.0.43±0.32 vs.0.45±0.20,P<0.05)。首发精神分裂症组的皮质静息期与一般症状得分呈负相关(r=-0.544,P<0.001),短间隔皮质抑制与阴性症状得分呈负相关(r=-0.501,P=0.005)。首发抑郁症组短间隔皮质抑制与汉密尔顿抑郁量表得分呈正相关(r=0.605,P=0.028)。结论首发精神分裂症和首发抑郁症均存在大脑皮质抑制指标异常,首发精神分裂症表现为皮质静息期延长,而首发抑郁症表现为短间隔皮质抑制减弱。首发精神分裂症和首发抑郁症的大脑皮质抑制指标异常与其临床症状相关。
Objective To compare cortical inhibition(CI)function between patients with schizophrenia and depression,and to explore the correlation between CI function and clinical symptoms.Methods A total of 35 first episode schizophrenia(FES)patients,41 depression patients(21 with first episode depression,20 with recurrent depression),and 35 healthy controls(HC)were recruited.The positive and negative syndrome scale(PANSS)was used to assess symptoms in FES patients,while the 17-item Hamilton depression scale(HAMD-17)and Hamilton anxiety scale(HAMA)were used to assess symptoms in depression patients.All participants’cortical inhibition and excitation measures were examined using single or paired pulses transcranial magnetic stimulation.Analysis of covariance/generalized linear model was employed to compare cortical inhibition and excitation measures among groups including age,gender,and medication status as covariates.The correlations between cortical inhibition and excitation measures and clinical symptoms were analyzed.Results The cortical silent period(CSP)in FES group was longer than that in control group and depression group[(92.08±35.43)ms vs.(70.27±22.12)ms vs.(70.81±29.29)ms,P<0.05].Depression group was further divided into first episode depression(FED)and recurrent depression(RD)subgroups.The short-interval cortical inhibition(SICI)was weaker in FED group than in the RD group and the control group(0.76±0.44 vs.0.43±0.32 vs.0.45±0.20,P<0.05).In FED group,CSP was negatively correlated with the general symptom score of PANSS(r=-0.544,P<0.001),and SICI was negatively correlated with the negative symptom score of PANSS(r=-0.501,P=0.005).In the FED group,SICI was positively correlated with HAMD-17 score(r=0.605,P=0.028).Conclusion Both FES patients and FED patients exhibit abnormal CI.There are distinct characteristics between FES and FED.FES patients exhibit prolonged CSP,while FED patients exhibit decreased SICI.The abnormal CI in FES and FED are correlated with their clinical symptoms.
作者
吴观福
朱田园
徐丽华
钱禛颖
王继军
唐莺莹
WU Guanfu;ZHU Tianyuan;XU Lihua;QIAN Zhenying;WANG Jijun;TANG Yingying(Department of EEG and Neuroimaging,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China.)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2024年第8期476-482,共7页
Chinese Journal of Nervous and Mental Diseases
基金
科技创新2030项目(编号:2022ZD0212800)
国家自然科学基金项目(编号:82171497,82151314)
上海市教育委员会高峰高原学科建设计划(编号:20191836)。
关键词
精神分裂症
抑郁症
神经抑制
皮质兴奋性
经颅磁刺激
短间隔皮质抑制
皮质静息期
Schizophrenia
Depression
Neural inhibition
Cortical excitability
Transcranial magnetic stimula-tion
Short interval cortical inhibition
Cortical silent period
