首發(fā)伴聽(tīng)幻覺(jué)偏執(zhí)型精神分裂癥加工音階錯(cuò)覺(jué)的神經(jīng)生理機(jī)制
發(fā)布時(shí)間：2019-03-02 11:07
【摘要】：背景 精神分裂癥是一種高致殘性疾病,其終身患病率為0.7%,我國(guó)現(xiàn)有患者780萬(wàn),其病因不明,機(jī)制不清,預(yù)后不良,社會(huì)影響巨大；進(jìn)一步了解其病因、病理、改善預(yù)后等具有重大的科研價(jià)值和社會(huì)意義。聽(tīng)幻覺(jué)是精神分裂癥的核心癥狀之一,與患者疾病的嚴(yán)重程度及預(yù)后密切相關(guān),因此對(duì)聽(tīng)幻覺(jué)機(jī)制的研究是本領(lǐng)域的重要課題。聽(tīng)錯(cuò)覺(jué)與聽(tīng)幻覺(jué)有著密切聯(lián)系,它們可能有著共同的加工腦區(qū),因此對(duì)聽(tīng)錯(cuò)覺(jué)的皮層加工機(jī)制的研究能部分揭示聽(tīng)幻覺(jué)的皮層加工機(jī)制。 目的 研究精神分裂癥聽(tīng)錯(cuò)覺(jué)狀態(tài)下皮層加工的特征及與臨床癥狀的關(guān)聯(lián)。 方法 1.首先我們?cè)?9名右利手正常健康人中測(cè)試了Deutsch音階錯(cuò)覺(jué)(Deutsch octave illusion)的加工模型,報(bào)告在左側(cè)聽(tīng)到高音者歸為RL (reporting left)組,報(bào)告在右側(cè)聽(tīng)到高音者歸為RR (reporting right)組。然后選取首發(fā)伴聽(tīng)幻覺(jué)偏執(zhí)型精神分裂癥患者23名,從上述29名被試中選取匹配的健康對(duì)照被試23名。 2.以Positive and Negative Syndrome Scale (PANSS)評(píng)定精神分裂癥患者癥狀嚴(yán)重程度。 3.以Deutsch音階錯(cuò)覺(jué)的刺激范式對(duì)上述被試進(jìn)行靜音、錯(cuò)覺(jué)的normal和reversed sequences的實(shí)驗(yàn),并記錄其腦電。 4.分析EEG theta功率值/任務(wù)相關(guān)功率值和相干性/任務(wù)相關(guān)相干性,并采用重復(fù)測(cè)量方差分析的方法比較各組、各狀態(tài)及不同皮層區(qū)域間的差異。 結(jié)果 1.在正常被試中,在normal和reversed sequences狀態(tài)刺激后,RL組和RR組被試在任務(wù)相關(guān)功率值上均表現(xiàn)出右側(cè)皮層高于左側(cè)；而RR組被試右側(cè)額中-顳半球內(nèi)任務(wù)相關(guān)相干系數(shù)高于RL組被試。 2.在分裂癥被試中,normal和reversed sequences狀態(tài)下,亦存在聽(tīng)錯(cuò)覺(jué)的右側(cè)加工優(yōu)勢(shì),但分裂癥患者雙側(cè)的任務(wù)相關(guān)功率值顯著低于健康對(duì)照組；而雙側(cè)額中-顳半球內(nèi)任務(wù)相關(guān)相干系數(shù)高于健康對(duì)照組。 3.分裂癥患者右側(cè)額中-顳區(qū)域任務(wù)相關(guān)功率值與PANSS聽(tīng)幻覺(jué)分值存在負(fù)相關(guān),而右側(cè)額中-顳區(qū)域半球內(nèi)任務(wù)相關(guān)相干系數(shù)與PANSS聽(tīng)幻覺(jué)分值存在正相關(guān)。 結(jié)論 1.右利手人群中,音階錯(cuò)覺(jué)片段能激起聽(tīng)覺(jué)加工相關(guān)區(qū)域額中葉和顳葉的活動(dòng)。 2.右利手人群音階錯(cuò)覺(jué)加工過(guò)程中,聽(tīng)覺(jué)優(yōu)勢(shì)(ear preference)與不同的額中-顳連結(jié)通路有關(guān)。 3.首發(fā)伴聽(tīng)幻覺(jué)的精神分裂癥患者在聽(tīng)錯(cuò)覺(jué)加工中,存在額中-顳區(qū)域低激活、高同步化的現(xiàn)象。 4.首發(fā)伴聽(tīng)幻覺(jué)的精神分裂癥患者在外源性錯(cuò)覺(jué)信息加工中存在皮層整合功能的障礙,包括自我監(jiān)控機(jī)制、抑制機(jī)制以及代償機(jī)制的作用。 5.首發(fā)伴聽(tīng)幻覺(jué)的精神分裂癥患者在錯(cuò)覺(jué)加工中,額中-顳區(qū)域低激活、高同步化的現(xiàn)象與癥狀的嚴(yán)重程度有關(guān)。 總之,音階錯(cuò)覺(jué)的加工能激起額中、顳區(qū)域的活動(dòng),其聽(tīng)覺(jué)優(yōu)勢(shì)與不同的額中-顳連結(jié)通路有關(guān)；精神分裂癥患者在聽(tīng)錯(cuò)覺(jué)加工中,存在額中-顳區(qū)域低激活、高同步化的現(xiàn)象,反映了皮層整合功能的障礙,并與癥狀的嚴(yán)重程度有關(guān)。
[Abstract]:background Schizophrenia is a high-disabling disease with a lifetime prevalence of 0.7%. In our country, 77.8 million people have an unknown etiology, unclear mechanism, poor prognosis and great social impact. It is of great scientific research value and social meaning to improve the prognosis and so on. The auditory hallucination is one of the core symptoms of schizophrenia and is closely related to the severity and prognosis of the patient's disease, so the study of the auditory hallucination mechanism is an important lesson in this field. The auditory illusion is closely related to the auditory hallucinations, and they may have a common processing brain area, so the study of the cortical processing mechanism of the auditory illusion can partially reveal the auditory hallucinations cortex processing machine. System. Objective To study the characteristics and clinical significance of subcortical processing in the auditory illusion of schizophrenia. symptoms Methods 1. First of all, we tested the processing model of the Deutsch's scale delusion in the normal healthy people of the 29 right hand healthy people. The report reported on the left to the RL (reporting left) group on the left, and the report on the right as RR (reporti Ng right). Then,23 of the first-episode paranoid schizophrenia patients were selected and matched from the above-mentioned 29 subjects. 23 healthy control subjects.2. Positive and Negative Syndrome Scale (PANSS) The severity of the patient's symptoms.3. The above-mentioned subjects were mute, delusion normal, and revered sequen with the stimulation paradigm of the illusion of the Deutsch scale. The EEG theta power value/ task-related power value and the coherence/ task-related coherence were analyzed, and the method of repeated measurement of variance was used to compare the groups. each Results 1. In normal trial, the RL group and RR group were tested at the task-related power values to show that the right cortex was higher than the left; while the RR group was tested on the right-hand side- 2. The task-related coherence coefficient in the semi-sphere is higher than that of the RL group.2. In the normal and the normal conditions, the right processing advantage of the auditory illusion is also present, but the two-sided task-related power value of the patient is significantly lower than that of the healthy control group; and the bilateral amount The correlation coefficient of the task-related power in the middle-lower hemisphere was higher than that of the healthy control group.3. The related power value of the task-related power in the right frontal area of the patient was negatively correlated with the auditory hallucination score of the PANSS, while in the right frontal area, there was a negative correlation with the auditory hallucination score of the PANSS. the phase of a retreat The correlation coefficient was positively correlated with the auditory hallucination score of PANSS. An activity in the middle and the middle of an auditory processing-related area. (ear preference) is associated with a different amount of the-link path.3. The first episode with the mental division of auditory hallucinations. In the process of auditory delusions, the patients with laceration have low activation and high synchronization in the frontal-low region.4. The first episode of schizophrenia with auditory hallucinations is stored in the information processing of exogenous illusion. The disorder of the whole function of the cortex, including the mechanism of self-monitoring, the mechanism of inhibition and the role of the compensatory mechanism.5. The first episode of schizophrenia with auditory hallucinations. In the process of delusion, the phenomenon of low activation and high synchronization in the frontal-middle region is related to the severity of the symptoms. In that case of schizophrenia, in the proces of auditory delusions, there is an in-and-middle area.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R749.3
本文編號(hào)：2432990
[Abstract]:background Schizophrenia is a high-disabling disease with a lifetime prevalence of 0.7%. In our country, 77.8 million people have an unknown etiology, unclear mechanism, poor prognosis and great social impact. It is of great scientific research value and social meaning to improve the prognosis and so on. The auditory hallucination is one of the core symptoms of schizophrenia and is closely related to the severity and prognosis of the patient's disease, so the study of the auditory hallucination mechanism is an important lesson in this field. The auditory illusion is closely related to the auditory hallucinations, and they may have a common processing brain area, so the study of the cortical processing mechanism of the auditory illusion can partially reveal the auditory hallucinations cortex processing machine. System. Objective To study the characteristics and clinical significance of subcortical processing in the auditory illusion of schizophrenia. symptoms Methods 1. First of all, we tested the processing model of the Deutsch's scale delusion in the normal healthy people of the 29 right hand healthy people. The report reported on the left to the RL (reporting left) group on the left, and the report on the right as RR (reporti Ng right). Then,23 of the first-episode paranoid schizophrenia patients were selected and matched from the above-mentioned 29 subjects. 23 healthy control subjects.2. Positive and Negative Syndrome Scale (PANSS) The severity of the patient's symptoms.3. The above-mentioned subjects were mute, delusion normal, and revered sequen with the stimulation paradigm of the illusion of the Deutsch scale. The EEG theta power value/ task-related power value and the coherence/ task-related coherence were analyzed, and the method of repeated measurement of variance was used to compare the groups. each Results 1. In normal trial, the RL group and RR group were tested at the task-related power values to show that the right cortex was higher than the left; while the RR group was tested on the right-hand side- 2. The task-related coherence coefficient in the semi-sphere is higher than that of the RL group.2. In the normal and the normal conditions, the right processing advantage of the auditory illusion is also present, but the two-sided task-related power value of the patient is significantly lower than that of the healthy control group; and the bilateral amount The correlation coefficient of the task-related power in the middle-lower hemisphere was higher than that of the healthy control group.3. The related power value of the task-related power in the right frontal area of the patient was negatively correlated with the auditory hallucination score of the PANSS, while in the right frontal area, there was a negative correlation with the auditory hallucination score of the PANSS. the phase of a retreat The correlation coefficient was positively correlated with the auditory hallucination score of PANSS. An activity in the middle and the middle of an auditory processing-related area. (ear preference) is associated with a different amount of the-link path.3. The first episode with the mental division of auditory hallucinations. In the process of auditory delusions, the patients with laceration have low activation and high synchronization in the frontal-low region.4. The first episode of schizophrenia with auditory hallucinations is stored in the information processing of exogenous illusion. The disorder of the whole function of the cortex, including the mechanism of self-monitoring, the mechanism of inhibition and the role of the compensatory mechanism.5. The first episode of schizophrenia with auditory hallucinations. In the process of delusion, the phenomenon of low activation and high synchronization in the frontal-middle region is related to the severity of the symptoms. In that case of schizophrenia, in the proces of auditory delusions, there is an in-and-middle area.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R749.3
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