The Electroretinogram May Differentiate Schizophrenia From Bipolar Disorder
The Electroretinogram May Differentiate Schizophrenia From Bipolar Disorder
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DOI：
10.1016/j.biopsych.2019.06.014
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发表时间：
2020-02-01
影响因子：
10.6
通讯作者：
Maziade, Michel
中科院分区：
文献类型：
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作者：
Hebert, Marc;Merette, Chantal;Maziade, Michel
背景：视网膜是大脑的一个可接近的部分，因为它们共同的胚胎起源。视网膜电图（ERG）已被证明是一个有价值的工具，调查精神疾病。因此，即使在平衡患者的主要抗精神病药物后，我们也研究了其作为区分精神分裂症（SZ）与双相情感障碍（BP）的工具的准确性。方法：记录了150名SZ患者和151名BP患者的ERG视锥和视杆亮度反应功能，并与200名对照组进行比较。我们创建了一个亚组的主题-45 SZ和45 BP平衡的主要抗精神病药物。结果：锥A波振幅降低和B波潜伏期延长观察到这两种疾病，而锥B波振幅降低是存在于SZ只。在两种疾病中均观察到混合杆锥a波和b波振幅降低。SZ患者与对照受试者的区分准确性为0.91，敏感性为77%，特异性为91%，BP患者的准确性为0.89，敏感性为76%，特异性为88%。SZ患者和BP患者的准确度分别为0.86（全样本）和0.83（45例患者的子样本，敏感性为80%，特异性为82%）。抗精神病药物的剂量与ERG parameters.CONCLUSIONS：在这项研究中使用的ERG波形参数提供了一个非常准确的区分两种疾病时，使用逻辑回归模型。这支持ERG作为一种工具，可以帮助临床医生在稳定的药物治疗患者中鉴别诊断SZ和BP。
BACKGROUND: The retina is recognized as an approachable part of the brain owing to their common embryonic origin. The electroretinogram (ERG) has proved to be a valuable tool to investigate psychiatric disorders. We therefore investigated its accuracy as a tool to differentiate schizophrenia (SZ) from bipolar disorder (BP) even after balancing patients for their main antipsychotic medication.METHODS: ERG cone and rod luminance response functions were recorded in 150 patients with SZ and 151 patients with BP and compared with 200 control subjects. We created a subgroup of subjects-45 with SZ and 45 with BP-balanced for their main antipsychotic medication.RESULTS: A reduced cone a-wave amplitude and a prolonged b-wave latency were observed in both disorders, whereas a reduced cone b-wave amplitude was present in SZ only. Reduced mixed rod-cone a- and b-wave amplitudes were observed in both disorders. Patients with SZ were distinguishable from control subjects with 0.91 accuracy, 77% sensitivity, and 91% specificity with similar numbers for patients with BP (0.89, 76%, and 88%, respectively). Patients with SZ and patients with BP could be differentiated with an accuracy of 0.86 (whole sample) and 0.83 (subsamples of 45 patients with 80% sensitivity and 82% specificity). Antipsychotic dosages were not correlated with ERG parameters.CONCLUSIONS: The ERG waveform parameters used in this study provided a very accurate distinction between the two disorders when using a logistic regression model. This supports the ERG as a tool that could aid the clinician in the differential diagnosis of SZ and BP in stabilized medicated patients.