精神分裂症感觉门控的脑机制及其与症状和认知的关系
文献类型：学位论文
| 作者 | 夏璐瑶
|
| 答辩日期 | 2021-12 |
| 文献子类 | 博士 |
| 授予单位 | 中国科学院心理研究所 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 张向阳 |
| 关键词 | 首发未服药精神分裂症 感觉门控 脑成像 认知障碍 机器学 习 |
| 学位名称 | 理学博士 |
| 学位专业 | 认知神经科学 |
| 其他题名 | The brain mechanism of sensory gating in schizophrenia and its relationship with symptoms and cognition |
| 中文摘要 | Sensory gating can filter irrelevant sensory information. It can suppress irrelevant stimuli before the information is transferred to higher-order areas for fine processing, thereby protecting the integrity of cognition. This is a well-adapted inhibitory function of the brain. Sensory gating defects represented by P50 inhibition defects are repeatedly found in schizophrenia, which may be related to the core symptoms of schizophrenia, which is clinical manifestations and cognitive impairment. However, the relationship between sensory gating and its neural mechanisms, clinical manifestations and cognitive impairment is still unclear. This study explored the sensory gating defects in patients with first-episode drug naïve schizophrenia through a three-part study to study the relationship between the representation of important brain areas related to sensory gating and clinical symptoms and cognitive impairment. Finally, the machine learning technology was used to predict the natural treatment efficacy and cognitive performance of patients with first-episode drug naive schizophrenia. First, based on the study of sensory gating defects in schizophrenia, this thesis explored its relationship with clinical symptoms and cognitive performance. The first part of the study recruited 111 first-episode drug naive schizophrenia patients and 172 healthy controls to participate in the study. The Positive and Negative Symptom Scale (PANSS) was used to assess the patients' psychopathological symptoms, and the Measurement and Treatment Research to Improve Cognition Schizophrenia Consensus Cognitive Battery (MCCB) and Electroencephalogram (EEG) system were dministered to assess the cognitive performance and P50 inhibition of the subjects. The results showed that the first-episode untreated schizophrenia patients have sensory gating defects represented by P50 inhibition defects, which are characterized by a long S 1 latency and general cognitive impairment. There were correlations between S2 amplitude and PANSS total score, S2 latency and cognitive factors, indicating that the P50 components may be related to the psychopathological manifestations of schizophrenia. S 1 and S2 incubation periods are correlated with BVMT-R scores, S1 amplitude and spatial span scores, indicating that the P50 components may be the biomarkers of cognitive impairment in first-episode drug naive schizophrenia patients. Second, this paper confirmed the brain representations related to sensory gating and explored its relationship with clinical symptoms and cognitive performance. The second part of the study recruited 48 first-episode drug naive schizophrenia patients participate in the study. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess the cognitive performance of patients with schizophrenia. The patient's psychopathological symptoms, cognitive performance, P50 inhibition were assessed. Magnetic resonance imaging (MRI) was used to record the patient's resting state function and structural image data. The results showed that the first-episode drug naive schizophrenia patients had correlations between gray matter volume (GMV) and functional connectivity (FC) and P50 components. There was a correlation between FC in these brain areas related to sensory gating and clinical symptoms and cognitive performance. Finally, the indicators related to sensory gating obtained in the first and second parts were used as features to explore whether they could be used to predict the future curative effect, clinical symptoms and cognitive performance of patients with schizophrenia. The third part of the study recruited the same subjects in the second part and collected data on their psychopathological symptoms, cognitive performance, and resting state functopm and structure after 3 months of natural treatment. The results showed that the total score of PANSS and its subscales, the total scores of RBANS and its subscale, including immediate memory, visuospatial/ constructional, delayed memory, of first-episode drug naive schizophrenia patients improved after 3 months of natural treatment. This improvement was also reflected in the structure and function of the brain, namely GMV and FC. At the same time, using the technology of machine learning, characterized by the FCz related to sensory gating obtained in the second study, realized the prediction of the response, efficacy and cognitive performance of the first-episode drug naive schizophrenic patients to natural therapy at the individual level. All the feature combinations including FCz showed the better results in prediction than single EEG data as feature. Overall, this study filled some gaps in sensory gating research in the first-episode drug naive schizophrenia population. Studies found that sensory gating defects exist in the early stages of first-episode drug naive schizophrenia. And there was a correlation between this defect and clinical symptoms as well as cognitive performance. The FC between these areas related to sensory gating was a biomarker for the clinical symptoms of first-episode drug naive schizophrenia patients. It could successfully predict the treatment response, efficacy and cognitive performance of first-episode drug naive schizophrenia patients. |
| 英文摘要 | 感觉门控可以对无关的感觉信息进行预筛选，在信息被转移到更高阶区域进行精细处理前，抑制不相关的刺激以保护认知的完整性。这是大脑的一种适应良好的抑制功能。以P50抑制缺陷为代表的感觉门控缺陷在精神分裂症中反复出现，可能与精神分裂症的核心症状，临床表现与认知障碍有关。但感觉门控及其神经机制与临床表现及认知障碍之间的关系还不清楚。本研究将通过三个部分的研究以探求首发精神分裂患者感觉门控缺陷及其涉及的重要脑区的表征与临床症状和认知障碍的关系，并通过机器学习的技术实现对精神分裂症患者自然治疗疗效及认知表现的预测。 首先，本论文在对精神分裂症感觉门控缺陷研究的基础上，探讨其与临床症状和认知表现的关系。第一部分的研究采用了111名首发未服药精神分裂症患者和172名健康对照者参与了这项研究。采用阳性与阴性症状量表(PANSS )评定患者的精神病理症状，精神分裂症共识认知成套测验(MCCB)和脑电图( EEG)系统评定被试的认知表现和P50抑制情况。结果表明首发未服药的精神分裂症患者存在以P50抑制缺陷为代表的感觉门控缺陷，其特点是较长的S1 潜伏期以及一般认知障碍。S2振幅与PANS S总分，S2潜伏期与认知因子之间存在相关，预示着P50成分可能与精神分裂症的精神病理表现有关。S1和S2潜伏期与B VMT-R得分，S1振幅与空间广度得分之间存在相关，预示着P50成分可能是首发未服药精神分裂症患者认知障碍的生物标志物。 其次，本论文确认了感觉门控有关的大脑表征并探究其与临床症状和认知表现的关系。第二部分的研究采用了48例首发未服药的精神分裂症患者参与了这项研究。神经心理状态评估的可重复电池(RB ANS)用于评估精神分裂症患者的认知能力。评定了患者的精神病理症状、认知表现、P50抑制情况。并使用磁共振成像(MRI }记录患者静息态功能与结构像的数据。首发未服药精神分裂症患者在基线时的灰质体积(GMV)和功能连接(FC)与P50成分之间均存在相关。这些与感觉门控有关的FC的Z分数(FCz }与临床症状及认知表现之间存在相关。 最后，以第一、二部分得到的与感觉门控有关的指标作为特征，探究其是否能够用于精神分裂症患者未来的疗效、临床症状及认知表现的预测。第三部分的研究采用了第二部分相同的被试，收集了其在3个月自然治疗后的精神病理症状、认知表现及静息态功能与结构像的数据。本研究发现首发未服药精神分裂症患者PANSS总分及其分量表、RBANS的即时记忆、视觉空间/结构、延迟记忆及总分在3个月的自然治疗后均有所提升。这种提升也反应在大脑的结构和功能表征上，即GMV和功能连接FC。同时，运用了机器学习的技术，以研究二中得到的与感觉门控有关的FCz为特征，实现了在个体水平上首发未服药的精神分裂症患者对自然治疗的反应、疗效及其认知表现的预测。且包含FCz的特征组合在预测中均表现为较单一EEG特征更优的结果。 总体来看，本研究补充了感觉门控研究在首发未服药精神分裂症人群中的相关研究，提供了新的视角。研究发现，感觉门控缺陷在首发精神分裂症早期就己经存在。且这种缺陷与临床症状和认知表现之间存在着相关。与感觉门控有关的区域之间的FC是首发未服药精神分裂症患者临床症状的生物标志物，可以成功对经过自然治疗的首发精神分裂症患者的治疗反应、疗效及认知表现进行预测。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/41173]  |
| 专题 | 心理研究所_认知与发展心理学研究室 |
| 推荐引用方式 GB/T 7714 | 夏璐瑶. 精神分裂症感觉门控的脑机制及其与症状和认知的关系[D]. 中国科学院心理研究所. 中国科学院心理研究所. 2021. |
入库方式： OAI收割
来源：心理研究所
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