Hypofrontality in neuroleptic-naive patients and in patients with chronic schizophrenia. Assessment with xenon 133 single-photon emission computed tomography and the Tower of London.
Hypofrontality in neuroleptic-naive patients and in patients with chronic schizophrenia. Assessment with xenon 133 single-photon emission computed tomography and the Tower of London.
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DOI：
10.1001/archpsyc.1992.01820120031006
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发表时间：
1992-12
影响因子：
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通讯作者：
N. Andreasen;K. Rezai;R. Alliger;V. Swayze;M. Flaum;P. Kirchner;Gregg Cohen;D. O'Leary
中科院分区：
文献类型：
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作者：
N. Andreasen;K. Rezai;R. Alliger;V. Swayze;M. Flaum;P. Kirchner;Gregg Cohen;D. O'Leary
“前额叶功能减退假说”得到了许多神经影像学研究的支持，但并非所有研究都支持，这可能是因为样本的异质性。本研究检查了三个不同的样本，允许评估各种混杂因素，如长期治疗的影响，疾病的慢性化，和呈现的现象：（1）13名抗精神病药初治的精神分裂症患者，（2）23名非初治的精神分裂症患者，他们相对慢性病，但至少3周没有药物治疗，（3）15名健康的正常志愿者。局部脑血流量测量使用单光子发射计算机断层扫描与氙133作为示踪剂。控制条件包括观看视频监视器上起伏的彩色形状，而实验任务是伦敦塔。我们观察到伦敦塔是一个相对特定的刺激左内侧额叶皮层（可能包括部分扣带回）在健康的正常志愿者。未使用过抗精神病药物的患者和未使用过抗精神病药物的患者都缺乏这一区域的激活，右顶叶皮层也缺乏一个相关区域（代表伦敦特别激活的回路）。只有阴性症状评分高的患者激活减少。这些结果表明，额叶功能减退与阴性症状有关，不是抗精神病药物治疗或疾病慢性化的长期效应。
The "hypofrontality hypothesis" has been supported by many neuroimaging studies, but not all, perhaps because of heterogeneity of samples. The present study examined three different samples that permitted assessment of a variety of confounders, such as effects of long-term treatment, chronicity of illness, and presenting phenomenology: (1) 13 neuroleptic-naive schizophrenic patients, (2) 23 nonnaive schizophrenic patients who had been relatively chronically ill but were medication free for at least 3 weeks, and (3) 15 healthy normal volunteers. Regional cerebral blood flow was measured using single-photon emission computed tomography with xenon 133 as the tracer. The control condition consisted of looking at undulating colored shapes on a video monitor, while the experimental task was the Tower of London. We observed the Tower of London to be a relatively specific stimulant of the left mesial frontal cortex (probably including parts of the cingulate gyrus) in healthy normal volunteers. Both the neuroleptic-naive and the nonnaive patients lacked this area of activation, as well as a related one in the right parietal cortex (representing the circuitry specifically activated by the Tower of London). Decreased activation occurred only in the patients with high scores for negative symptoms. These results suggest that hypofrontality is related to negative symptoms and is not a long-term effect of neuroleptic treatment or of chronicity of illness.