DEVELOMENT OF AUTOMATICITY

需要回答的关键基础和临床研究问题将在五项研究中解决，以了解精神分裂症的自律性缺陷。一项对正常参与者的横断面研究将检验以下假设，即存在一个一般的技能获得因素，以及新纹状体是各种任务技能获得的早期阶段的共同神经底物。自动化与负功能相关的假设 还将测试内侧颞叶和新纹状体之间的连通性，以及技能自动化程度的提高与任务特定皮质神经网络中聚焦的fMRI激活有关。第二项横断面研究将在第一项研究中使用的相同任务中将精神分裂症患者与正常参与者进行比较，以检验精神分裂症患者自动化新技能的速度较慢的假设。精神分裂症的自律性缺陷与fMRI激活所反映的神经活动异常模式有关的假设也将得到检验。第三项横断面研究将通过比较精神分裂症患者和正常对照组随机练习和阻止练习的效果，来测试关于促进技能获得的条件的假设。第四项研究使用纵向设计来检验这一假设，即在前驱阶段转化为精神病的前驱患者与未转化为精神病的前驱患者和正常对照组相比，新技能的自动化比率降低。转化为精神分裂症的前驱患者的这些行为差异被假设反映在fMRI异常激活模式上。在第五项研究中，我们将确定技能自动化的比率是否可以预测功能结果，以及在疾病过程中的变化。这些研究的一个重要特点是使用双任务探测器来提供不同任务实现的自动化水平的独立指标。通过确定特定的大脑系统作为潜在的治疗靶点，阐明自律性缺陷的神经底物可能有助于开发新的精神分裂症躯体治疗方法。测试关于不同训练条件对技能获得的影响的假设将为为精神分裂症患者设计新的行为康复计划提供见解。

Key basic and clinical research questions that need to be answered to understand defective automaticity in schizophrenia will be addressed in five studies. A cross-sectional study of normal participants will test hypotheses that there is a general skill acquisition factor, and that the neostriatum is the common neural substrate in early stages of skill acquisition for a wide variety of tasks. The hypotheses that automation is associated with negative functional connectivity between the mesial temporal lobes and the neostriatum and that increased automatization of skills is associated with focalized fMRI activation in task specific cortical neural networks will also be tested. A second cross-sectional study will compare schizophrenia patients to normal participants on the same tasks used in the first study to test the hypothesis that patients with schizophrenia are slower to automate new skills. The hypothesis that defective automaticity in schizophrenia is associated with abnormal patterns of neural activity reflected in fMRI activation will also be tested. A third cross-sectional study will test hypotheses about conditions that facilitate skill acquisition by comparing the effect of random vs. blocked practice in schizophrenia patients and normal controls. A fourth study uses a longitudinal design to test the hypothesis that prodromal patients who convert to psychosis during the prodromal phase show a decreased rate of automation of new skills compared to prodromal patients who do not convert to psychosis and normal controls. These behavioral differences in prodromal patients who convert to schizophrenia are hypothesized to be reflected in abnormal patterns of fMRI activation. We will determine if rate of skill automation predicts functional outcomes, and changes over the course of the disorder in a fifth study. An important feature of these studies is the use of dual-task probes to provide independent indices of the level of automaticity achieved on different tasks. Elucidating the neural substrate for defective automaticity may contribute to the development of new somatic treatments for schizophrenia by identifying specific brain systems as potential therapeutic targets. Testing hypotheses about the effects of different training conditions on skill acquisition should offer insights into the design of novel behavioral rehabilitation programs for patients with schizophrenia.