Longitudinal studies of antisaccades in antipsychotic-naive first-episode schizophrenia
Longitudinal studies of antisaccades in antipsychotic-naive first-episode schizophrenia
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DOI：
10.1017/s0033291705006756
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发表时间：
2006-04-01
影响因子：
6.9
通讯作者：
Sweeney, JA
中科院分区：
文献类型：
--
作者：
Harris, MSH;Reilly, JL;Sweeney, JA
背景在精神分裂症的神经心理学和脑成像研究中已经报道了前额叶皮质功能障碍，包括适应性情境特异性行为的障碍。一些数据表明，抗精神病药物治疗可能会改善这些缺陷。我们调查了39例首次发作的精神分裂症患者的抗精神病药物初治的抗accade表现，这些患者在治疗开始后6周进行了重新评估。在相似的时间点检查一组匹配的健康受试者。患者和健康个体可用于长期测试重新评估后26和52周的初始测试。在治疗前，患者表现出反应抑制错误率升高和正确的反跳延迟。在单独的视觉引导扫视任务中，反扫视错误率的增加与更快的反应延迟相关，但仅在治疗前。在整个1年的随访中，患者的自我抑制能力逐渐提高。虽然治疗分配是由临床医生选择的，但探索性分析的结果显示，接受利培酮治疗的患者比接受氟哌啶醇治疗的患者更快地逐步计划和启动正确的抗accade。缺陷的空间注意力的自愿控制被夸大在急性发作的疾病，但仍然是一个持久的方面，前额叶功能障碍的精神分裂症，即使在治疗后。在急性疾病期间，加速的感觉运动转换可能会使这些缺陷复杂化，并导致与急性精神病相关的高度注意力分散。在整个1年的随访中，任务表现的持续改善表明，抗精神病药物治疗导致的前额叶认知功能的部分正常化可能比急性精神病症状的减少具有更长和更渐进的时间过程。
Background. Prefrontal cortical dysfunctions, including disturbances in adaptive context-specific behavior, have been reported in neuropsychological and brain imaging Studies of schizophrenia. Some data suggest that treatment with antipsychotic medications may ameliorate these deficits.Method. We investigated antisaccade performance in 39 antipsychotic-naive, first-episode schizophrenia patients who were re-evaluated 6 weeks after treatment initiation. A group of matched healthy Subjects were examined at similar time-points. Patients and healthy individuals available for longer-term testing were re-assessed 26 and 52 weeks after initial testing.Results. Before treatment, patients showed elevated rates of response suppression errors and prolonged latencies of correct antisaccades. Increased rates of antisaccade errors were associated with faster response latencies during a separate, Visually guided saccade task, but Only prior to treatment. Throughout the 1-year follow-up, patients progressively improved in their ability to Voluntarily suppress context-inappropriate behavior. Although treatment assignment was by clinician choice, results, of exploratory analyses revealed that patients treated with risperidone progressively planned and initiated correct antisaccades more quickly than patients receiving haloperidol.Conclusions. Deficits in the Voluntary control of spatial attention are exaggerated during acute episodes of illness, but remain an enduring aspect of prefrontal dysfunction in schizophrenia even after treatment. During acute Illness, speeded sensorimotor transformations May compound these deficits and contribute to the heightened distractibility associated With acute psychosis. Continued improvement in task performance throughout the 1-year follow-up Suggests that partial normalization of prefrontal cognitive functions resulting from antipsychotic treatment may have a longer and more gradual time course than the reduction of acute psychotic symptoms.