Auditory change detection in schizophrenia: sources of activity, related neuropsychological function and symptoms in patients with a first episode in adolescence, and patients 14 years after an adolescent illness-onset.
Auditory change detection in schizophrenia: sources of activity, related neuropsychological function and symptoms in patients with a first episode in adolescence, and patients 14 years after an adolescent illness-onset.
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DOI：
10.1186/1471-244x-6-7
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发表时间：
2006-02-08
期刊：
影响因子：
4.4
通讯作者：
Röpcke B
中科院分区：
文献类型：
--
作者：
Oades RD;Wild-Wall N;Juran SA;Sachsse J;Oknina LB;Röpcke B
事件相关脑反应失配负性(MMN)记录了听觉刺激的变化，其中颞叶来源反映了短期回声记忆，额叶来源反映了异常诱导的加工切换。精神分裂症发作时存在有争议的损害，发展迅速，并可以保持独立于临床改善。我们研究了头皮记录的MMN的特征，并将这些特征与短时记忆和定势转移测试联系起来。我们评估了相同的偶极子来源是否在青春期发病时就已经受到影响，以及这些特征在青春期发病后14年的病程中有何不同。分析和说明了青春期精神分裂症病程早期和晚期MMN活动的额叶和颞叶来源的强度、潜伏期、方位和位置。MMN是一种检测听觉变化的指标，它是在一个3音奇怪的演示中由短的异常音调诱发的，并在32个头皮电极上进行了记录。四个偶极子源被放置在假设引导的计算之后，使用脑图谱和磁共振图像上的脑电源分析。进行了一组简短的神经心理测试。我们比较了28名青春期首发精神分裂症患者和18名青春期确诊14年后的患者与来自社区的两组年龄匹配的对照组(分别为22名和18名)。MMN在年轻受试者中达到峰值的时间早于年长受试者。在患者中，尤其是年轻组，波幅降低，并与阴性症状和缓慢的定势转移有关。在首发患者中，颞叶来源比对照组更腹侧，而左侧扣带回和右侧额叶中下部来源更尾侧。在老年患者中，左侧颞叶仍位于腹侧(发育停滞)，右侧颞叶位于更前外侧(病情进展)，右侧额叶前移(正常化)。从疾病开始，健康组和患者组的偶极模型就有所不同。活性差异来源的不同特征表现为随着病程的延长而改善、停滞或恶化。MMN活动来源的变化及其与选择性信息处理和存储的关系的确切性质取决于特定的精神病理学和疾病的不同病程。
The event-related brain response mismatch negativity (MMN) registers changes in auditory stimulation with temporal lobe sources reflecting short-term echoic memory and frontal sources a deviance-induced switch in processing. Impairment, controversially present at the onset of schizophrenia, develops rapidly and can remain independent of clinical improvement. We examined the characteristics of the scalp-recorded MMN and related these to tests of short-term memory and set-shifting. We assessed whether the equivalent dipole sources are affected already at illness-onset in adolescence and how these features differ after a 14-year course following an adolescent onset. The strength, latency, orientation and location of frontal and temporal lobe sources of MMN activity early and late in the course of adolescent-onset schizophrenia are analysed and illustrated. MMN, a measure of auditory change-detection, was elicited by short deviant tones in a 3-tone oddball-presentation and recorded from 32 scalp electrodes. Four dipole sources were placed following hypothesis-led calculations using brain electrical source analysis on brain atlas and MR-images. A short neuropsychological test battery was administered. We compared 28 adolescent patients with a first episode of schizophrenia and 18 patients 14 years after diagnosis in adolescence with two age-matched control groups from the community (n = 22 and 18, respectively). MMN peaked earlier in the younger than the older subjects. The amplitude was reduced in patients, especially the younger group, and was here associated with negative symptoms and slow set-shifting. In first-episode patients the temporal lobe sources were more ventral than in controls, while the left cingular and right inferior-mid frontal sources were more caudal. In the older patients the left temporal locus remained ventral (developmental stasis), the right temporal locus extended more antero-laterally (illness progression), and the right frontal source moved antero-laterally (normalised). From the start of the illness there were differences in the dipole-model between healthy and patient groups. Separate characteristics of the sources of the activity differences showed an improvement, stasis or deterioration with illness-duration. The precise nature of the changes in the sources of MMN activity and their relationship to selective information processing and storage depend on the specific psychopathology and heterogeneous course of the illness.