Neurophysiological Evidence of Corollary Discharge Function During Vocalization in Psychotic Patients and Their Nonpsychotic First-Degree Relatives
Neurophysiological Evidence of Corollary Discharge Function During Vocalization in Psychotic Patients and Their Nonpsychotic First-Degree Relatives
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DOI：
10.1093/schbul/sbs129
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发表时间：
2013-11-01
影响因子：
6.6
通讯作者：
Sweeney, John A.
中科院分区：
文献类型：
--
作者：
Ford, Judith M.;Mathalon, Daniel H.;Sweeney, John A.
对运动行为产生的感觉的预测是通过神经机制（如推论放电）来实例化的。伴随着每一个动作，必然的放电提供了一个无意识的比较，预测和实际的感觉之间产生的行动;更接近的匹配导致更大的抑制的感觉。这种机制在精神分裂症（SZ）中被破坏，可能导致或反映了无法区分自我和外部产生的经验，这是精神病的标志。我们询问是否中断是特定于SZ或在其他精神病疾病和精神病患者的一级亲属中看到。在SZ患者（n = 30）、情感障碍（SA）患者（n = 19）、有精神病史的双相情感障碍患者（BPP; n = 39）、SZ患者（n = 30）、SA患者（n = 23）和BPP患者（n = 50）的非精神病性亲属以及健康对照组（n = 43）中评估了推论放电功能。事件相关电位的N1成分反映了听觉皮层对声音的反应，当受试者说话时，以及后来当他们听这些声音的录音时，会由语音开始引起。N1被抑制在谈话期间相比，N1在听，一致的抑制作用的必然放电机制。SZ和BPP患者的抑制显著降低，较小SA组的趋势相似。患者组没有差异，未受影响的亲属与对照组或先证者没有差异。无法监测自我产生的行为所导致的感觉，暗示必然的放电功能障碍，可能是情感性和非情感性精神病的共同特征。未受影响的家庭成员的数据并不表明这是精神病风险的标志。
Predictions about sensations resulting from motor acts are instantiated through neural mechanisms such as the corollary discharge. With each action, the corollary discharge provides an unconscious comparison between predicted and actual sensations resulting from the action; closer matches result in greater suppression of sensation. This mechanism is disrupted in schizophrenia (SZ) and may contribute to, or reflect a failure to, distinguish self- from externally generated experiences, a hallmark of psychosis. We asked whether disruption is specific to SZ or is seen in other psychotic illnesses and in first-degree relatives of psychotic patients. Corollary discharge function was assessed in SZ patients (n = 30), schizoaffective (SA) patients (n = 19), bipolar patients with a history of psychosis (BPP; n = 39), nonpsychotic relatives of SZ (n = 30), SA (n = 23), and BPP (n = 50) patients, and healthy controls (n = 43). The N1 component of the event-related potential, reflecting auditory cortical responses to sounds, was elicited by speech sound onset as subjects talked and later when they listened to a recording of those sounds. N1 was suppressed during talking compared to N1 during listening, consistent with the suppressive action of the corollary discharge mechanism. Suppression was significantly reduced in SZ and BPP patients, with a similar trend in the smaller SA group. Patient groups did not differ, and unaffected relatives did not differ from controls or probands. The failure to monitor sensations resulting from self-generated actions, implicating corollary discharge dysfunction, may be a common feature across affective and nonaffective psychosis. Data from unaffected family members do not indicate that this is a marker of psychosis risk.