Memory systems in schizophrenia: Modularity is preserved but deficits are generalized.
Memory systems in schizophrenia: Modularity is preserved but deficits are generalized.
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DOI：
10.1016/j.schres.2015.08.014
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发表时间：
2015-10
影响因子：
4.5
通讯作者：
Cannon TD
中科院分区：
文献类型：
--
作者：
Haut KM;Karlsgodt KH;Bilder RM;Congdon E;Freimer NB;London ED;Sabb FW;Ventura J;Cannon TD
精神分裂症患者表现出工作记忆和情景记忆受损，但这可能代表着跨记忆模式的全面性损害或仅限于患者亚组中特定记忆系统的表现缺陷。此外，目前还不清楚缺陷是否与其他疾病相关的缺陷是独一无二的。健康对照组(n=1101)和精神分裂症(n=58)、双相情感障碍(n=49)和注意缺陷多动障碍(n=46)患者进行了18项任务，主要涉及语言和空间情节和工作记忆。研究人员比较了不同任务的群体对比效应大小，并测量了受试者在不同记忆领域的分布位置的一致性。精神分裂症患者在每一项测试中的表现都比其他组差。虽然在记忆域之间发现了低到中等的相关性(r=.320)，支持这些系统的模块化，但关于每个人的任务表现的衡量标准(ICC=.292)与识别那些落在最低五分之一的人(kappa=0.259)之间的一致性有限。在对表现不佳的人进行分类时，总体能力因素几乎解释了所有群体在表现和衡量标准上的一致性差异。精神分裂症涉及的病理生理过程似乎主要作用于所有任务所需的一般能力，而不是不同记忆领域和模式中的特定能力。这些影响代表了一般能力总体分布的普遍转变(即，每个病例的功能水平低于如果没有疾病的情况下的水平)，而不是存在表现普遍较差的患者亚群。几乎没有证据表明精神分裂症的记忆障碍与双相情感障碍和ADHD相同。
Schizophrenia patients exhibit impaired working and episodic memory, but this may represent generalized impairment across memory modalities or performance deficits restricted to particular memory systems in subgroups of patients. Furthermore, it is unclear whether deficits are unique from those associated with other disorders. Healthy controls (n=1101) and patients with schizophrenia (n=58), bipolar disorder (n=49) and attention-deficit-hyperactivity-disorder (n=46) performed 18 tasks addressing primarily verbal and spatial episodic and working memory. Effect sizes for group contrasts were compared across tasks and the consistency of subjects’ distributional positions across memory domains was measured. Schizophrenia patients performed poorly relative to the other groups on every test. While low to moderate correlation was found between memory domains (r=.320), supporting modularity of these systems, there was limited agreement between measures regarding each individual’s task performance (ICC=.292) and in identifying those individuals falling into the lowest quintile (kappa=0.259). A general ability factor accounted for nearly all of the group differences in performance and agreement across measures in classifying low performers. Pathophysiological processes involved in schizophrenia appear to act primarily on general abilities required in all tasks rather than on specific abilities within different memory domains and modalities. These effects represent a general shift in the overall distribution of general ability (i.e., each case functioning at a lower level than they would have if not for the illness), rather than presence of a generally low-performing subgroup of patients. There is little evidence that memory impairments in schizophrenia are shared with bipolar disorder and ADHD.