The neural substrates of impaired prosodic detection in schizophrenia and its sensorial antecedents.
The neural substrates of impaired prosodic detection in schizophrenia and its sensorial antecedents.
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DOI：
10.1176/ajp.2007.164.3.474
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发表时间：
2007-03
期刊：
影响因子：
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通讯作者：
D. Leitman;M. Hoptman;John J. Foxe;Erica Saccente;G. Wylie;J. Nierenberg;M. Jalbrzikowski;K. Lim;D. Javitt
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文献类型：
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作者：
D. Leitman;M. Hoptman;John J. Foxe;Erica Saccente;G. Wylie;J. Nierenberg;M. Jalbrzikowski;K. Lim;D. Javitt
目的精神分裂症患者根据发声变化(情感韵律)解码情绪的能力存在严重缺陷。这项研究用扩散张量磁共振成像(MRI)的体素分析研究了精神分裂症患者韵律功能障碍的神经基础。方法采用语音情绪识别测验(VoiceiD)对19例精神分裂症患者和19例正常对照进行情感韵律测试，同时进行基本音高知觉和执行加工测试(威斯康星卡片分类测验)。采用扩散张量磁共振分数各向异性瓣膜进行体素相关分析。在后续实验中，对另外24名患者和17名对照受试者的非情绪性韵律感知任务的表现进行了评估。结果患者表现出明显的VoiceiD缺陷和扭曲的Tunes任务表现。语音功能受损与初级和次级听觉通路、眶前叶皮质、胼胝体和杏仁核周围白质的各向异性分数值降低显著相关。扭曲的曲调任务表现受损也与听觉和杏仁核通路中较低的分数各向异性有关，但与前额叶皮质无关。精神分裂症患者的威斯康星卡片分类测验成绩主要与前额叶分数各向异性有关。在后续研究中，在非情绪性韵律表现方面也观察到了显著的缺陷，以及感觉、情感性韵律和非情感性韵律之间的显著相互关系。结论精神分裂症与初级听皮层的结构和功能障碍有关。这些缺陷显著地导致患者无法解码言语的情感和语义方面，突显了感觉异常在精神分裂症患者社会沟通功能障碍中的重要性。
OBJECTIVE Individuals with schizophrenia show severe deficits in their ability to decode emotions based upon vocal inflection (affective prosody). This study examined neural substrates of prosodic dysfunction in schizophrenia with voxelwise analysis of diffusion tensor magnetic resonance imaging (MRI). METHOD Affective prosodic performance was assessed in 19 patients with schizophrenia and 19 comparison subjects with the Voice Emotion Identification Task (VOICEID), along with measures of basic pitch perception and executive processing (Wisconsin Card Sorting Test). Diffusion tensor MRI fractional anisotropy valves were used for voxelwise correlation analyses. In a follow-up experiment, performance on a nonaffective prosodic perception task was assessed in an additional cohort of 24 patients and 17 comparison subjects. RESULTS Patients showed significant deficits in VOICEID and Distorted Tunes Task performance. Impaired VOICEID performance correlated significantly with lower fractional anisotropy values within primary and secondary auditory pathways, orbitofrontal cortex, corpus callosum, and peri-amygdala white matter. Impaired Distorted Tunes Task performance also correlated with lower fractional anisotropy in auditory and amygdalar pathways but not prefrontal cortex. Wisconsin Card Sorting Test performance in schizophrenia correlated primarily with prefrontal fractional anisotropy. In the follow-up study, significant deficits were observed as well in nonaffective prosodic performance, along with significant intercorrelations among sensory, affective prosodic, and nonaffective measures. CONCLUSIONS Schizophrenia is associated with both structural and functional disturbances at the level of primary auditory cortex. Such deficits contribute significantly to patients' inability to decode both emotional and semantic aspects of speech, highlighting the importance of sensorial abnormalities in social communicatory dysfunction in schizophrenia.