儿童首发精神分裂症患者和正常儿童前脉冲抑制的对照研究

doi:10.3969/j.issn.1674-8115.2023.05.011

上海交通大学学报（医学版） ›› 2023, Vol. 43 ›› Issue (5): 606-610.doi: 10.3969/j.issn.1674-8115.2023.05.011

• 论著 · 临床研究 • 上一篇

儿童首发精神分裂症患者和正常儿童前脉冲抑制的对照研究

徐晓君¹(), 叶敏捷¹(), 王玉城²(), 王文霞¹, 钱胜¹, 叶丹弟¹, 潘乐乐¹, 胡欣¹, 尹晓莉¹, 李美花¹, 林光耀¹

^1.温州医科大学附属康宁医院公共卫生科，浙江省精神心理疾病临床医学研究中心，温州 325007
^2.上海市静安区精神卫生中心老年科，上海 200436

收稿日期:2023-01-03 接受日期:2023-02-22 出版日期:2023-05-28 发布日期:2023-07-11
通讯作者: 叶敏捷,王玉城 E-mail:562058107@qq.com;minjieye@163.com;284382038@qq.com
作者简介:徐晓君（1980—），女，主治医师，学士；电子信箱：562058107@qq.com。
基金资助:
浙江省医药卫生科技计划(2023KY306)

A comparative study of prepulse inhibition in children with first episode schizophrenia and normal children

XU Xiaojun¹(), YE Minjie¹(), WANG Yuchen²(), WANG Wenxia¹, QIAN Sheng¹, YE Dandi¹, PAN Lele¹, HU Xin¹, YIN Xiaoli¹, LI Meihua¹, LING Guangyao¹

^1.Department of Public Health, The Affiliated Kangning Hospital of Wenzhou Medical University; Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou 325007, China
^2.Department of Geriatrics, Jingan District Mental Health Center, Shanghai 200436, China

Received:2023-01-03 Accepted:2023-02-22 Online:2023-05-28 Published:2023-07-11
Contact: YE Minjie,WANG Yuchen E-mail:562058107@qq.com;minjieye@163.com;284382038@qq.com
Supported by:
Medical and Health Science and Technology Plan of Zhejiang Province(2023KY306)

摘要/Abstract

摘要：

目的·采用前脉冲抑制（prepulse inhibition，PI）新技术评价儿童首发精神分裂症（childhood onset schizophrenia，COS）患者感觉门控及其变异特点。方法·应用事件相关电位仪，采用单独强刺激和弱刺激+强刺激范式，对56例COS患者和38名正常儿童（normal children，NC）进行PI检测，并用阳性和阴性症状量表（Positive and Negative Syndrome Scale，PANSS）、社会功能缺陷筛选量表（Social Disability Screening Schedule，SDSS）、社会支持量表（Social Adjustment Rating Scale，SSRS）、家庭负担会谈量表（Family Interview Schedule，FIS）等4个量表对COS患者进行综合评估。结果·比对上述量表形成的社会客观支持度与社会支持量标准值［（8±2）分］，COS组数值为（10±3）分，两者差异具有统计学意义（P=0.007）。未发现PI与PANSS量表总分、各因子分的相关性（均P>0.05）。COS组比NC组单独强刺激的惊跳反射潜伏期延长［NC组为（86±11）ms，COS组为（97±13）ms，P=0.001］。COS组比NC组弱刺激+强刺激的惊跳反射波幅增高，潜伏期延长［NC组波幅为（39±12）μV，COS组波幅为（47±21）μV，P=0.007；NC组潜伏期为（84±17）ms，COS组（97±20）ms，P=0.003］。COS组PI抑制率低于NC组［NC组抑制率为（66±32）%，COS组抑制率为（43±37）%，P=0.000］。结论·COS患者同成人精神分裂症一样存在PI异常。PI变化可能是反映COS患者激越情绪变化的生物学标记的结果。

关键词: 精神分裂症, 儿童, 前脉冲抑制, 生物学标记

Abstract:

Objective ·To explore the characteristics of sensory gating and its variation in children with first episode schizophrenia (COS) by using a new technique of prepulse suppression (PI). Methods ·By using the ERP recording and analysis system of brain products, PI was detected in 56 patients with COS and 38 healthy children (NC) using the paradigm of single strong stimulus and weak stimulus+strong stimulus. The patients′ performance was comprehensively evaluated with Positive and Negative Syndrome Scale (PANSS), Social Disability Screening Schedule (SDSS), Social Adjustment Rating Scale (SSRS), and Family Interview Schedule (FIS). Results ·The social objective support formed by summing up the above scales was compared with the quantitative stanard of social support [the standard of social support scale was (8±2) points, and the value of COS group was (10±3) points], and the difference was statistically significant (P=0.007). No correlation was found between PI and PANSS total score and each factor score (all P>0.05). The latency of startle reflex in the COS group was longer than that in the NC group [the NC group was (86±11) ms, the COS group was (97±13) ms, P=0.001]. In the COS group, the amplitude of startle reflex of weak stimulus+strong stimulus was higher, and the latency was longer than that of the NC group [NC group: (39±12) μV, COS group (47±21) μV, P=0.007; the latency of the normal group was (84±17) ms, and that of the COS group was (97±20) ms, P=0.003]. PI inhibition rate in the COS group was lower than that in the NC group [(66±32) % in the NC group, (43±37) % in the COS group, P=0.000]. Conclusion ·COS patients have the same PI abnormality as adult schizophrenia. The change of PI inhibition may be the result of biological markers reflecting the change of agitated emotion in COS patients.

Key words: schizophrenia, children, prepulse inhibition (PI), biological markers (BM)

中图分类号:

R749.94

徐晓君, 叶敏捷, 王玉城, 王文霞, 钱胜, 叶丹弟, 潘乐乐, 胡欣, 尹晓莉, 李美花, 林光耀. 儿童首发精神分裂症患者和正常儿童前脉冲抑制的对照研究[J]. 上海交通大学学报（医学版）, 2023, 43(5): 606-610.

XU Xiaojun, YE Minjie, WANG Yuchen, WANG Wenxia, QIAN Sheng, YE Dandi, PAN Lele, HU Xin, YIN Xiaoli, LI Meihua, LING Guangyao. A comparative study of prepulse inhibition in children with first episode schizophrenia and normal children[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(5): 606-610.

图/表 3

参考文献 16

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Project	COS group	NC group	t/χ²	P value
Project	(n=56)	(n=38)	t/χ²	P value
Age	14.3±1.3	13.4±1.5	1.495	0.122
Gender (male/female)/[n (%)]	29 (51.2)/27 (48.8)	20 (52.6)/18 (47.4)	0.656	0.412
Nation	Han nationality	Han nationality	N/A	N/A
Hearing	Normal	Normal	N/A	N/A
Family history of mental disorder	No	No	N/A	N/A
Year of education/year	6.5±1.2	6.4±1.3	0.591	0.551
Course of disease/month	3.80±2.7	N/A	N/A	N/A
PANSS total/score	98±10.5	N/A	N/A	N/A
Positive symptom/score	25.2±4.2	N/A	N/A	N/A
Negative symptom/score General sychopathology/score	23.9±7.9	N/A	N/A	N/A
Negative symptom/score General sychopathology/score	36.7±5.4	N/A	N/A	N/A

Project	COS group	NC group	t/χ²	P value
Project	(n=56)	(n=38)	t/χ²	P value
Age	14.3±1.3	13.4±1.5	1.495	0.122
Gender (male/female)/[n (%)]	29 (51.2)/27 (48.8)	20 (52.6)/18 (47.4)	0.656	0.412
Nation	Han nationality	Han nationality	N/A	N/A
Hearing	Normal	Normal	N/A	N/A
Family history of mental disorder	No	No	N/A	N/A
Year of education/year	6.5±1.2	6.4±1.3	0.591	0.551
Course of disease/month	3.80±2.7	N/A	N/A	N/A
PANSS total/score	98±10.5	N/A	N/A	N/A
Positive symptom/score	25.2±4.2	N/A	N/A	N/A
Negative symptom/score General sychopathology/score	23.9±7.9	N/A	N/A	N/A
Negative symptom/score General sychopathology/score	36.7±5.4	N/A	N/A	N/A

Index	PI	R
PANSS scale point total	0.11	0.42
Positive scale point	0.07	0.54
Negative scale point	0.12	0.33
General psychosis scale point	0.12	0.44
Lack response factor	0.11	0.42
Thinking disorder factor	0.03	0.76
Activeness factor	0.27	0.04
Paranoia factor	0.16	0.17
Depressed factor	0.06	0.56

Index	PI	R
PANSS scale point total	0.11	0.42
Positive scale point	0.07	0.54
Negative scale point	0.12	0.33
General psychosis scale point	0.12	0.44
Lack response factor	0.11	0.42
Thinking disorder factor	0.03	0.76
Activeness factor	0.27	0.04
Paranoia factor	0.16	0.17
Depressed factor	0.06	0.56

Group	n	Single strong stimulation		Weak stimulation+strong stimulation		PI%
Group	n	Latency/ms	Amplitude/μV	Latency/ms	Amplitude/μV	PI%
Cz Brain region
NC group	38	86±11	72±39	84±17	39±12	66±32
COS group	56	97±13^①	74±41	97±20^②	47±21^③	43±37^④
Fz Brain region
NC group	38	87±9	71±38	83±17	38±12	65±31
COS group	56	96±13^⑤	72±40	96±20^⑥	39±20	43±36^①
Pz Brain region
NC group	38	86±10	70±37	83±16	37±11	66±32
COS group	56	85±12	88±40^③	89±19	46±20^⑦	44±31^④

儿童首发精神分裂症患者和正常儿童前脉冲抑制的对照研究

A comparative study of prepulse inhibition in children with first episode schizophrenia and normal children

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