Neural Patterns of Visual Learning in Schizophrenia

描述（由申请人提供）：精神分裂症是一种具有多种症状表现的疾病，可分为三个领域：(1)现实扭曲（幻觉和妄想），(2)阴性症状（精神运动迟缓），(3)混乱（思维障碍）。我们之前已经将不同的rCBF模式与阳性和阴性症状域联系起来，支持rCBF在症状亚型之间存在差异的观点。除症状外，精神分裂症患者在智力、记忆、注意力和执行功能测试中表现出不充分的神经心理表现。使用功能磁共振成像（fMRI）进行血氧水平依赖对比（BOLD）分析，关注精神分裂症亚型（特定症状组）的综合神经生物学问题，将当代研究技术应用于复杂的临床脑/行为障碍。我们将评估15名原发性持续性阴性症状的精神分裂症患者（缺乏性精神分裂症或DS）和15名主要幻觉和妄想的精神分裂症患者（现实扭曲或RD）在视觉DMST上的表现改善。我们预测，患有精神分裂症的志愿者将表现出学习能力，但缺陷组将无法像RD组那样取得进步，因为缺陷组的志愿者将无法使用反馈来增强他们的学习能力。利用BOLD信号的变化，我们将定义盲视和盲视志愿者在学习视觉DMST过程中的神经活动模式。在知觉训练后，RD会表现出前扣带血流动力学反应的显著增加。在训练前后，DS志愿者的下顶叶BOLD反应明显降低。持续的原发性阴性症状也有望阻止扣带皮层的反馈依赖性变化。

DESCRIPTION (provided by applicant): Schizophrenia is an illness with multiple symptom manifestations that cluster into at three domains: (1) reality distortion (hallucinations and delusions), (2) negative symptoms (psychomotor retardation), and (3) disorganization (thought disorder). We have previously associated distinctive rCBF patterns with positive and negative symptom domains, supporting the idea of rCBF differences across symptom subtypes. In addition to symptoms, persons with schizophrenia show inadequate neuropsychological performance when evaluated on test of intelligence, memory, attention, and executive function. Blood oxygen level dependent contrast (BOLD) analysis using fMRI, focused on questions of integrative neurobiology in schizophrenia subtypes (particular symptom groups), brings a contemporary research technique to bear on a complex clinical brain/behavior disorder. We will assess performance improvement on a visual DMST with feedback in 15 schizophrenic patients with primary enduring negative symptoms (Deficit Schizophrenia or DS) and 15 schizophrenic patients with predominant hallucinations and delusions (Reality Distortion or RD). We predict that schizophrenic volunteers will show learning but that the deficit group will fail to improve as much as the RD group because the deficit volunteers will not be able to use feedback to enhance their learning. Using BOLD signal changes we will define the neural activity patterns in DS and RD volunteers during learning of the visual DMST. The RD will exhibit a significant increase in the anterior cingulate hemodynamic response after perceptual training. DS volunteers will exhibit a significantly reduced BOLD response in the inferior parietal lobe before and after training. Enduring primary negative symptoms are also expected to prevent feedback-dependent changes in the cingulate cortex.