EPILEPSY AS A NEUROLOGICAL MODEL OF SCHIZOPHRENIA

癫痫作为精神分裂症的神经学模型

• 批准号: 6246211
• 负责人: LAURA MARSH
• 金额: $ 3.61万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-05-15 至 1997-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6246211
• 关键词: clinical research; electroencephalography; electrophysiology; epilepsy; frontal lobe /cortex; human subject; magnetic resonance imaging; model; neuroanatomy; pathologic process; schizophrenia; sign /symptom; temporal lobe /cortex

Neuroanatomical abnormalities reported in idiopathic schizophrenia (ISZ) include evidence for focal as well as global nonspecific neuropathology. These abnormalities are often subtle and it is uncertain which are specific to pathogenesis and clinical symptoms. Comparison of patients with epilepsy who share analogous symptoms with ISZ enables identification of converging brain abnormalities which may be specific to the schizophrenic syndrome. Though seizures are not a feature of ISZ, the two conditions have commonalities: schizophrenia-like states occur in ictal, post-ictal, or interictal phases of epilepsy and medial temporal, neurodevelopmental, and electrophysiological abnormalities are implicated in each. While ictal and post-ictal psychosis are related to discrete electrophysiological events, interictal schizophrenia-like illness may represent additional brain disease, i.e.,structural pathology, not related to seizure generation. In particular, the associated neuropathology should be over and above that seen in epilepsy without ISZ-like symptoms. Using clinical assessments and quantitative MRI and EEG methods, the broad research objectives of this project are to identify converging clinical, neuroanatomical, and electrophysiological features, and clinicopathological relationships in ISZ as compared to epilepsy with interictal schizophrenia-like synptoms(ESZ) and localization-related epilepsy of unilateral temporal lobe origin (TLE) without interictal psychosis. Healthy controls will provide normative MRI data. Such knowledge will help establish the location, specificity, and pathophysiological significance of abnormalities in ISZ and further direct studies of regional neuropathology and brain dysfunction in ISZ to focus on areas of etiologic significance. The specific aims are to test whether (1) ISZ and ESZ share a commmon profile of positive symptoms (hallucinations, delusions, and thought disorder) and negative symptoms (e.g., flat affect and amotivation); (2) ISZ and ESZ share a profile of predominant frontal and temporal lobe neocortical structural abormalities, whereas TLE shows hippocampal and neocortical deficits predominantly in the epileptogenic temporal lobe; (3) ISZ and ESZ show more background EEG slowing, especially in frontal and temporal regions, relative to TLE in which focal slowing is concordant with the seizure focus. Epileptiform discharges (ED) are most abundant and multifocal in ESZ, less frequent and concordant with the seizure focus in TLE, and rare in ISZ; and, (4) Positive and negative symptoms are related to MRI and EEG abnormalities in neocortical temporal and frontal lobes, respectively. EEG slowing & ED are associated with tissue abnormalities in corresponding electrical fields.

特发性精神分裂症（ISZ）中报告的神经解剖学异常 包括局灶性和全局非特异性神经病理学证据。 这些异常往往是微妙的，它是不确定的， 特异于发病机制和临床症状。 患者比较 与ISZ有类似症状的癫痫患者， 识别可能是特异性的会聚性脑异常 精神分裂综合症 虽然癫痫发作不是 ISZ，这两种情况有共同点：精神分裂症样状态 发生在癫痫的发作期、发作后或发作间期， 颞叶、神经发育和电生理异常 牵连在每一个。虽然发作期和发作后精神病与 离散的电生理事件，发作间期精神分裂症样 疾病可能代表另外的脑部疾病，即，结构 病理学，与癫痫发作无关。 特别是 相关的神经病理学应该超过癫痫 没有类似ISZ的症状 使用临床评估和定量MRI和EEG方法， 该项目的广泛研究目标是确定聚合 临床、神经解剖和电生理特征，以及 ISZ与癫痫的临床病理关系 发作间期精神分裂症样综合征（ESZ）和定位相关 不伴发作间期的单侧颞叶癫痫 精神病 健康对照将提供规范的MRI数据。 等 知识将有助于确定位置，特异性， ISZ异常的病理生理学意义， 直接研究ISZ中的局部神经病理学和脑功能障碍 关注病因学上的重要性 具体的目的是检验（1）ISZ和ESZ是否共享一个common 阳性症状（幻觉、妄想和思维） 病症）和阴性症状（例如，情绪低落和动力不足）;（2） ISZ和ESZ的特征是额叶和颞叶占主导地位 新皮质结构异常，而TLE显示海马和 致痫性颞叶的新皮质缺损; (3)ISZ和ESZ显示更多的背景EEG减慢，尤其是在额叶 和颞区，相对于TLE，其中局灶性减慢是 与癫痫病灶一致 癫痫样放电（艾德）是 在ESZ中最丰富和多灶性，频率较低，与 癫痫灶在TLE，在ISZ少见;（4）阳性， 阴性症状与MRI和EEG异常有关， 分别为新皮质颞叶和额叶。 脑电图减慢和艾德 与相应的电生理组织异常有关 领域的