上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (9): 1133-.doi: 10.3969/j.issn.1674-8115.2010.09.027

• 论著（临床研究） • 上一篇    下一篇

精神分裂症首发患者利培酮治疗前后事件相关脑电位N400的动态观察

陈兴时1, 徐一峰2, 唐云翔3, 肖泽萍2, 张明岛1, 王继军4, 楼翡璎1, 陈 冲1   

  1. 1.上海交通大学 |医学院附属精神卫生中心神经生理室, 上海 200030；2.上海交通大学 |医学院附属精神卫生中心精神科, 上海 200030；3.第二军医大学心理学教研室, 上海 200433；4.上海交通大学 |医学院附属精神卫生中心脑电影像室, 上海 200030
  • 出版日期:2010-09-25 发布日期:2010-09-27
  • 通讯作者: 徐一峰, 电子信箱: hyyyyb@gmail.com；王继军, 电子信箱: oukeigun@yahoo.com.cn。
  • 作者简介:陈兴时（1957—）, 男, 教授；电子信箱: chenxingshi2008@163.com。
  • 基金资助:

    国家自然科学基金（30770772, 30971046）；国家重点基础研究发展计划(“973”计划) （2010CB529605）；国家高技术研究发展计划(“863”计划)（2008AA02Z412，2007AA02Z420）

Changes of event related potential component N400 in first episode schizophrenia before and after risperidone treatment

CHEN Xing-shi1, XU Yi-feng2, TANG Yun-xiang3, XIAO Ze-ping2, ZHANG Ming-dao1, WANG Ji-jun4, |LOU Fei-ying1, |CHEN Chong1   

  1. 1.Department of Electrophysiology, 2. Department of Psychiatry, Shanghai Mental Health Center, |Shanghai Jiaotong University School of Medicine, Shanghai 200030, China；3.Department of Psychology, The Second Military Medical University of PLA, Shanghai 200433, China；4.Department of Electronic Encephalography Source Imaging, Shanghai Mental Health Center, |Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
  • Online:2010-09-25 Published:2010-09-27
  • Supported by:

    National Natural Science Foundation of China, 30770772, 30971046；National Basic Research Program of China, “973” program, 2010CB529605；National High Technology Research and Development Program of China, “863” program, 2008AA02Z412, 2007AA02Z420

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摘要：

目的 研究首发精神分裂症（FES）患者事件相关脑电位(ERP)N400的变异与临床症状和治疗的关系，并探讨变异性质及相关机制。方法 应用中国润杰WJ-1型ERP仪，采用汉语成语正常结尾字（匹配）与汉语成语结尾歧义字（非匹配）模式，对56例FES患者（FES组）和62名健康成人（NC组）进行N400指标检测；并用阳性和阴性症状量表（PANSS）评定患者的精神症状。FES患者给予利培酮片单一药物治疗，分别于治疗3个月和12个月时进行N400随访。结果 ①与NC组比较，FES组患者治疗前N400潜伏期在Cz、Pz、Fz 3个脑区明显延迟于对照组，波幅下降；②在Cz脑区，FES患者的N400潜伏期延迟与PANSS量表的一般精神病理量表得分呈正相关(r=0.319,P<0.05)，N400波幅下降与阳性症状分和PANSS总分呈负相关（r=-0.425,P<0.01;r=-0.348,P<0.05）。③治疗3个月后，FES组患者的精神症状评分未见明显变化；与治疗前比较N400潜伏期和波幅差异无统计学意义（P>0.05）。治疗12个月后，FES组患者的精神症状开始缓解，PANSS量表总分为（29.5±3.3）分，减分率>50%；N400指标也相应改善，表现为潜伏期前移和波幅升高（P<0.05或P<0.01）。结论 FES患者在发病初期存在认知功能和语言缺陷，随访提示精神分裂症的N400变化是状态标志。

关键词: 精神分裂症, N400, 诱发电位, 利培酮, 疗效

Abstract:

Objective To explore the relationship between event related potential (ERP) component N400 changes and syndromes and treatment in first episode schizophrenia (FES), and investigate the mechanism of N400 changes. Methods Chinese sentences with matching (congruent) or mismatching (incongruent) ending words were used as stimuli, and ERP component N400 was recorded by Runjie WJ-1 ERP instrument (China) in 56 patients with FES (FES group) and 62 healthy controls (NC group). Psychiatric symptoms were assessed by Positive and Negative Syndrome Scale (PANSS). Patients in FES group were treated by single antipsychotic drug risperidone, and N400 was monitored after treatment for 3 months and 12 months in both groups. Results Compared with NC group, N400 latencies in Cz, Pz and Fz prolonged, and N400 amplitudes decreased in FES group. In Cz of FES group, the prolonged N400 latency was positively correlated to the general psychopathological score in PANSS (r=0.319, P<0.05）, and the decreased N400 amplitude was negatively correlated to the positive score and total score of PANSS （r=-0.425,P<0.01;r=-0.348,P<0.05）. Compared with those before treatment, no significant changes were found in PANSS score, N400 latencies and N400 amplitudes in FES group after treatment for 3 months (P>0.05). Twelve months after treatment, psychiatric symptoms in FES group relieved, and the total PANSS score decreased to 29.5±3.3, with a score-reducing rate >50%. Improved N400 indexes were also observed, with shortened N400 latencies and enlarged N400 amplitudes （P<0.05 or P<0.01）. Conclusion Cognitive and linguistic disorders can be found in patients with FES, and N400 changes may be a state marker for schizophrenia.

Key words: schizophrenia, N400, evoked potential, risperidone, treatment effect