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首发精神分裂症神经软体征与认知功能的相关性
王碧馨袁念袁廉邹思蕴赵雪莉吕笑丽袁颖张广亚殷铭李哲杜向东
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摘要:
目的 探索研究神经系统软体征(NSS)与认知功能在首发精神分裂症患者与健康人群中 的差异及相关性。方法 2015 年10 月至2016 年4 月选取36 例首次发作精神分裂症患者和37 名健康对 照,采用剑桥心理自动化成套测试(CANTAB)中的快速视觉信息处理(RVP)、剑桥袋球(SOC)项目进行认 知功能评定,分析两组注意、记忆以及执行功能的差异。采用剑桥神经系统检查(CNI)软体征测试分量 表检测两组间神经系统软体征的差异,并了解NSS 与临床症状以及认知功能之间的相关性。结果 精 神分裂症组与健康对照组相比,除SOC 测验中的平均步数(4 步)差异无统计学意义(P> 0.05)以外,RVP 及SOC 各项指标的差异均有统计学意义(P< 0.05)。精神分裂症患者CNI软体征测试分量表总分9.50 (7.00,13.75)分、原始反射分2.00(2.00,2.00)分、运动协调分8.00(5.00,11.75)分均显著高于健康对照组 4.00(3.00,5.00)、2.00(2.00,2.00)、2.00(0,3.00)分,差异均有统计学意义(P< 0.05)。CNI 软体征测试分 量表总分与年龄(r=0.553,P < 0.001)呈中等程度正相关,与性别、受教育年限无相关性(P > 0.05)。在 控制了年龄后,CNI 软体征测试分量表原始反射分与PANSS 阴性症状得分呈中等程度正相关(r=0.412, P=0.024);运动协调分与RVP各项均有相关性(P< 0.05),与SOC 最少步数完成的任务数呈中等程度负 相关(r=-0.419,P=0.001);总分与RVP各项均有相关性(P< 0.05),与SOC 最少步数完成的任务数呈弱负 相关(r=-0.395,P=0.002)。结论 首发精神分裂症患者NSS 及认知功能均有不同程度损害,且两者之间 存在一定相关性。
关键词:  精神分裂症  神经系统软体征  认知功能
DOI:10.3969/j.issn.1009-6574.2019.03.007
基金项目:苏州市临床医学专家团队引进项目(SZYJTD201715);苏州市临床医学中心(Szzx201509); 苏州市临床重点病种诊疗技术专项(LCZX201515);苏州市科技发展计划项目(SYSD2017135)
Relationship between neurological soft signs and cognition function in first-episode schizophrenia
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Abstract:
Objectives To investigate the differences and correlations between the neurological soft signs( NSS) and cognitive functions for first-episode schizophrenia patients. Methods From October 2015 to April 2016, 36 patients with first-episode schizophrenia and 37 healthy controls were selected. Subjects' cognitive functions were assessed using the Rapid Visual Information Processing( RVP) and Stockings of Cambridge( SOC) in the Cambridge Neuropsychological Test Automated Battery( CANTAB). Cognitive function assessment was performed to analyze differences in attention, memory, and executive function between the two groups. The Cambridge Neurological Inventory's( CNI) soft sign subscale was used to detect differences in neurological soft signs between the two groups and to understand the association between NSS and clinical symptoms and cognitive function. Results Compared with the healthy control group, the schizophrenia group's average number of moves in the SOC test( 4 moves) was not statistically significantly different( P>0.05), while all the other RVP and SOC indicators were statistically significantly different( P<0.05). The total score of CNI soft signs, the original reflex score and the exercise coordination score in the schizophrenia group were 9.50 (7.00, 13.75), 2.00( 2.00, 2.00), and 8.00( 5.00, 11.75), respectively, which were all significantly higher than those of the healthy control group[ 4.00( 3.00, 5.00), 2.00( 2.00, 2.00), 2.00( 0, 3.00), P<0.05]. The total score of the CNI soft sign subscale was moderately positively correlated with age( r=0.553, P<0.001), and had no correlation with gender and years of education( P>0.05). Controlling for age, the primary reflex score of the CNI soft sign subscale was moderately positively correlated with the negative symptom score in the Positive and Negative Syndrome Scale( PANSS, r=0.412, P=0.024). The motor coordination score was correlated with RVP (P < 0.05), and was moderately negative related to the number of tasks completed with the minimum number of SOC moves( r=-0.419, P=0.001). The total score of the CNI soft sign subscale was correlated with all RVP indicators ( P< 0.05) and was slightly negatively related to the number of tasks completed with the minimum number of SOC moves( r=-0.395, P=0.002). Conclusions NSS and cognitive function both have different degrees of damages in patients with first-episode schizophrenia. And there is a certain correlation between the two.
Key words:  Schizophrenia  Neurological soft signs  Cognitive function

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