精神分裂症患者童年创伤与认知功能损害、敌意归因偏向和自我怜悯能力的相关性研究

摘要 目的：探讨精神分裂症患者童年创伤与认知功能损害、敌意归因偏向和自我怜悯能力的相关性。方法：选取2019年3月至2021年6月我院收治的70例精神分裂症患者（精神分裂症组）和53例社区健康志愿者（对照组）。采用童年创伤问卷（CTQ）、中文版精神分裂症认知功能成套测验（MCCB）、中文版模棱两可、目的和敌意问卷（AIHQ-C）、中文版自我怜悯量表（SCS-C）评估所有受试人员的童年创伤、认知功能、敌意归因偏向和自我怜悯能力。Pearson相关分析精神分裂症患者CTQ评分与MCCB、AIHQ-C、SCS-C评分的相关性。结果：精神分裂症组CTQ各分量表评分及总分、AIHQ-C各项目评分及总分均高于对照组（P＜0.05）;精神分裂症组MCCB各项目评分及总分、SCS-C各因子（自我友善、普遍人性、正念）评分及总分均低于对照组（P＜0.05）。Pearson相关性分析结果显示,精神分裂症患者CTQ总分与MCCB总分、SCS-C总分呈负相关（r=-0.327、-0.470,P＜0.05）,与AIHQ-C总分呈正相关（r=0.362,P＜0.05）。结论：精神分裂症患者的童年心理创伤水平较高,且与当前认知功能受损、敌意归因偏向和自我怜悯水平降低有关。     

La schizophrénie, pathologie de la conscience? Ou comment les bonnes idées peuvent renaître...

Episodic memory corresponds to a state of consciousness called “autonoetic” which is characterized by the fact the subject is able to consciously remember a past personal life event. The subject is able to recall his autobiographical life, personal and individual and to encompass consciously a future prefiguration by the means of the autonoetic consciousness. The unique and personal characteristics of our memories are linked to relations between conscious remembering and self consciousness. This link can explain that the same event being lived by different subjects can lead to different reported memories. Conscious remembering is a phenomenon that highly contributes to one’s own identity building. Subjective conscious remembering which accompanies the personal memory recuperation is impaired in schizophrenics. This subjective conscious remembering state impairment will provoke the loss or alteration of the capacity of past event revival. Conscious remembering is impaired whereas familiarity is preserved in schizophrenics. Conscious remembering deficit is both quantitative and qualitative: we can observe a fragmentation of the subjective experience, schizophrenics are not able to gather different parts of an event to build a unique representation. This conscious remembering deficit is secondary to an impairment of episodic memories construction. The Jean-Marie Danion’s model places the specific disease deficit at the top of the cognitive building, the consciousness level. This deficit would produce the cognitive dysfunctions shape observed in schizophrenia and would be at the origin of some of the symptoms of the disease.     

Measurement of dopamine D2-like receptors in postmortem CNS and pituitary: differential regional changes in schizophrenia

In situ radioligand binding with autoradiography and anti-human dopamine D(2) receptor antibodies with Western blots have been used to measure the density of dopamine D(2)-like receptors in the caudate-putamen and pituitary from schizophrenic subjects who did or did not have residual antipsychotic drugs in their tissue at death. There was a significant decrease in the Ki for haloperidol displaceable [(125)I]iodosulpride binding in the pituitary (p < 0.01) and caudate-putamen (p < 0.05) from subjects with schizophrenia with residual drugs in their tissue. There was a significant decrease in the density of [(125)I]iodosulpride in the pituitary (p < 0.001) and a strong trend to a decrease in binding in the caudate-putamen (p = 0.055) from subjects with schizophrenia. By contrast, [(3)H]spiperone binding was decreased in the caudate-putamen (p < 0.05) with a trend to decreased binding in the pituitary (p = 0.07) from subjects with schizophrenia. There was no difference in the density of dopamine D(2) receptors in the caudate-putamen from subjects with schizophrenia (p = 0.31). All the findings on receptor densities were independent of drug status. [(125)I]iodosulpride binds to the dopamine D(2&3) receptors. We have shown that there is no change in the dopamine D(2) receptor in the caudate-putamen from subjects with schizophrenia and therefore, these data would be consistent with there being a decrease in the dopamine D(3) in the caudate-putamen from subjects with schizophrenia. Since dopamine D(3) receptors are absent or present at low concentrations in the pituitary, our data would suggest the dopamine D(2) receptor is decreased in that tissue from schizophrenic subjects.     

Increased turnover of platelet phosphatidylinositol in schizophrenia.

The potential role of receptor-stimulated phosphatidylinositol (PI) hydrolysis in a signal transduction mechanism has been increasingly recognized. Earlier studies have suggested a defect in alpha-adrenergic receptor function in the platelets of schizophrenic patients. Little is known, however, about the mechanisms for PI synthesis, breakdown, and regulation in schizophrenia. The present study was undertaken to investigate the metabolic turnover of inositol phospholipids and inositol phosphates by incorporation of [3H]myoinositol or [32P]orthophosphate into resting and activated platelets of normal controls and schizophrenic patients with and without neuroleptic treatment. After 5 h incubation at 37 degrees C, the majority of [3H]myoinositol was incorporated into platelet PI. Following thrombin-induced platelet activation, there was rapid formation of 3H-labeled inositol phosphates (IPs) with inositol monophosphate (IP1) being the most abundant product. The thrombin-induced formation of platelet IPs was found significantly higher in both haloperidol-stabilized and drug-free schizophrenics than in normal control subjects. When platelets were prelabeled with [32P]orthophosphates, thrombin-induced formation of phosphatidic acid (PA) was also significantly higher in haloperidol-stabilized schizophrenics than in normal controls. It is thought that thrombin-induced platelet activation is mediated through hydrolysis of polyphosphoinositides (poly-PI). The present data thus may reflect an increased signal transduction in schizophrenia, which is mediated through neuroleptic-regulated inositol phospholipid hydrolysis.     

Neural Correlates of Belief and Emotion Attribution in Schizophrenia

Impaired mental state attribution is a core social cognitive deficit in schizophrenia. With functional magnetic resonance imaging (fMRI), this study examined the extent to which the core neural system of mental state attribution is involved in mental state attribution, focusing on belief attribution and emotion attribution. Fifteen schizophrenia outpatients and 14 healthy controls performed two mental state attribution tasks in the scanner. In a Belief Attribution Task, after reading a short vignette, participants were asked infer either the belief of a character (a false belief condition) or a physical state of an affair (a false photograph condition). In an Emotion Attribution Task, participants were asked either to judge whether character(s) in pictures felt unpleasant, pleasant, or neutral emotion (other condition) or to look at pictures that did not have any human characters (view condition). fMRI data were analyzing focusing on a priori regions of interest (ROIs) of the core neural systems of mental state attribution: the medial prefrontal cortex (mPFC), temporoparietal junction (TPJ) and precuneus. An exploratory whole brain analysis was also performed. Both patients and controls showed greater activation in all four ROIs during the Belief Attribution Task than the Emotion Attribution Task. Patients also showed less activation in the precuneus and left TPJ compared to controls during the Belief Attribution Task. No significant group difference was found during the Emotion Attribution Task in any of ROIs. An exploratory whole brain analysis showed a similar pattern of neural activations. These findings suggest that while schizophrenia patients rely on the same neural network as controls do when attributing beliefs of others, patients did not show reduced activation in the key regions such as the TPJ. Further, this study did not find evidence for aberrant neural activation during emotion attribution or recruitment of compensatory brain regions in schizophrenia.     

Is Our Self Nothing but Reward? Neuronal Overlap and Distinction between Reward and Personal Relevance and Its Relation to Human Personality

Background

The attribution of personal relevance, i.e. relating internal and external stimuli to establish a sense of belonging, is a common phenomenon in daily life. Although previous research demonstrated a relationship between reward and personal relevance, their exact neuronal relationship including the impact of personality traits remains unclear.

Methodology/Principal Findings

Using functional magnetic resonance imaging, we applied an experimental paradigm that allowed us to explore the neural response evoked by reward and the attribution of personal relevance separately. We observed different brain regions previously reported to be active during reward and personal relevance, including the bilateral caudate nucleus and the pregenual anterior cingulate cortex (PACC). Additional analysis revealed activations in the right and left insula specific for the attribution of personal relevance. Furthermore, our results demonstrate a negative correlation between signal changes in both the PACC and the left anterior insula during the attribution of low personal relevance and the personality dimension novelty seeking.

Conclusion/Significance

While a set of subcortical and cortical regions including the PACC is commonly involved in reward and personal relevance, other regions like the bilateral anterior insula were recruited specifically during personal relevance. Based on our correlation between novelty seeking and signal changes in both regions during personal relevance, we assume that the neuronal response to personally relevant stimuli is dependent on the personality trait novelty seeking.     

IL-28B genetic variant is associated with the risk of schizophrenia in the Chinese Han population

Schizophrenia is a severe psychiatric disorder. Although its exact cause is unknown, it is widely accepted that environmental factors and genes integrate in the pathogenesis of schizophrenia. 19q13, which contains IL-28B, is a newly identified potential susceptibility locus. IL-28B is a cytokine that functionally has anti-viral activity, but, structurally, is related to the interleukin-10 family. Both virus infection and cytokine changes have been documented in schizophrenia. We selected the single-nucleotide polymorphism rs8099917, which is associated with IL-28B gene expression, to study its relationship to the susceptibility to schizophrenia. A total of 256 Chinese patients with schizophrenia and 329 healthy controls were studied. Both genotype and allele frequencies showed significant differences between patients and normal subjects (p=0.03 and p=0.04, respectively). Our study suggested that the frequency of allele T was a risk factor for the susceptibility of schizophrenia (odds ratio [OR]=1.76, 95% confidence interval [CI]=1.03-3.03). When all subjects were grouped by symptoms, both the genotype and the allele frequency were associated with patients having disorganized speech (genotype: χ(2)=5.75, p=0.02; allele: χ(2)=5.41, p=0.02, OR=3.67, 95% CI=1.14-11.82) and negative symptoms (genotype: χ(2)=5.09, p=0.02; allele: χ(2)=4.80, p=0.03, OR=1.95, 95% CI=1.06-3.56) as well as cognitive symptoms (genotype: χ(2)=5.97, p=0.02; allele: χ(2)=5.53, p=0.02, OR=2.04, 95% CI=1.11-3.74). The results in this study may lead to a better understanding of the etiology of schizophrenia.     

Electrophysiological evidence for right frontal lobe dominance in spatial visuomotor learning

Slow negative potential shifts were recorded together with the error made in motor performance when two different groups of 14 students tracked visual stimuli with their right hand. Various visuomotor tasks were compared. A tracking task (T) in which subjects had to track the stimulus directly, showed no decrease of error in motor performance during the experiment. In a distorted tracking task (DT) a continuous horizontal distortion of the visual feedback had to be compensated. The additional demands of this task required visuomotor learning. Another learning condition was a mirrored-tracking task (horizontally inverted tracking, hIT), i.e. an elementary function, such as the concept of changing left and right was interposed between perception and action. In addition, subjects performed a no-tracking control task (NT) in which they started the visual stimulus without tracking it. A slow negative potential shift was associated with the visuomotor performance (TP: tracking potential). In the learning tasks (DT and hIT) this negativity was significantly enhanced over the anterior midline and in hIT frontally and precentrally over both hemispheres. Comparing hIT and T for every subject, the enhancement of the tracking potential in hIT was correlated with the success in motor learning in frontomedial and bilaterally in frontolateral recordings (r = 0.81-0.88). However, comparing DT and T, such a correlation was only found in frontomedial and right frontolateral electrodes (r = 0.5-0.61), but not at the left frontolateral electrode. These experiments are consistent with previous findings and give further neurophysiological evidence for frontal lobe activity in visuomotor learning. The hemispherical asymmetry is discussed in respect to hemispherical specialization (right frontal lobe dominance in spatial visuomotor learning).     

Studies of trans-3-methyl-2-hexenoic acid in normal and schizophrenic humans

The report that sweat of certain schizophrenics contains the branched chain fatty acid, trans-3-methyl-2-hexenoic acid (TMHA), stimulated an investigation to evaluate the relationship between this fatty acid and schizophrenia. A sensitive and specific gas-liquid chromatography-mass spectroscopic procedure was developed for analyzing biological fluids for TMHA. Analysis of sweat samples from normal and schizophrenic subjects indicated that the sweat of both groups contains comparable quantities of this fatty acid. In addition, the fate of intravenously administered (14)C-labeled TMHA was shown to be similar in normal and schizophrenic subjects. It is concluded that there is no relationship between TMHA and schizophrenia.     

Association of SLC18A1, TPH1, and RELN gene polymorphisms with risk of paranoid schizophrenia

A biochip was developed to examine the polymorphisms of genes associated with schizophrenia risk, including DISC1, RELN, ZNF804A, PLXNA2, COMT, SLC18A1, CACNA1C, ANK2, TPH1, PLAA, and SNAP-25. Allele and genotype frequencies of the genes were determined in 198 schizophrenics and 192 healthy subjects from Bashkortostan (ethnic Russians and Tatars). The frequencies of allele A (p = 0.007) and genotype AA (p = 0.002) of the rs2270641 A>C polymorphism of SLC18A1 in the patients with paranoid schizophrenia was lower than in the healthy subjects. The frequency of genotype AA of the rs1800532 C>A polymorphism of TPH1 in the schizophrenics was higher than in the healthy subjects (p = 0.036). Compared with the healthy subjects, the ethnic Tatar patients with paranoid schizophrenia had a lower frequency of allele C of the rs7341475 C>T polymorphism of RELN (p = 0.039) and a higher frequency of genotype AA of the rs1800532 C>A polymorphism of TPH1 (p = 0.019, OR = 2.52, CI 1.18-5.38). The frequency of allele C (p = 0.0001) and genotype GC (p = 0.0001) of the rs1327175 G>C polymorphism of PLXNA2 was elevated in the patients with a family history of paranoid schizophrenia. Based on the results, the SLC18A1, TPH1, and RELN polymorphisms were associated with risk of schizophrenia.     

Les symptômes de premier rang de la schizophrénie: de la clinique à l’approche expérimentale

Theoretical models about action monitoring and action attribution developed over the last ten years have given a new framework in the understanding of first-rank symptoms of schizophrenia, as described by Kurt Schneider. Impaired action attribution has been demonstrated in patients with first-rank symptoms. Moreover, positron emission tomography studies have revealed that the cortical network involved in action attribution processes in normal subjects is not correctly activated in patients with first-rank symptoms. These results demonstrate that these symptoms are related to cognitive and cerebral correlates and they shed new light on the understanding of psychotic symptoms.     

Brain monoamine oxidase in schizophrenia

The content of SH-groups and substrate specificity have been studied in purified preparations of monoamine oxidase (MAO) from human brain. It has been shown that both in schizophrenic and mentally normal persons MAO occurs in a partially oxidized state. The enzyme contains 2 SH-groups per 10(5) daltons of protein and deaminates MAO substrates (serotonin, beta-phenylethylamine) along with histamine, diamine oxidase substrate. Reduction of the partially oxidized SH-groups of MAO in schizophrenics up to 15 SH-groups per 10(5) daltons of protein (the normal value for human brain MAO) does not eliminate the histamine deaminase activity as is the case in experiments with MAO from the normal brain but, on the contrary, considerably potentiates it. The data suggest certain structural alteration of MAO in schizophrenia.     

Neuropsychological Characteristics of Cortical and Subcortical Zones of the Human Brain as Multidimensional Genetic Risk Factors of Schizophrenia

A neuropsychological study of 59 families with schizophrenia (193 subjects: 59 patients, 109 parents, and 25 sibs) was conducted using the methods of A.R. Luria. The control group included 23 healthy subjects without a familial history of schizophrenia. The analysis revealed a wide spectrum of mental disorders in schizophrenics and their relatives but not in the control group. The disorders varied from vague to distinct. The most informative for discrimination of the subject groups were interrelated integrative characteristics of the left and right subcortical, left subcortico-frontal, and left subcortico-temporal areas. The errors of discrimination between schizophrenics and control subjects (a low-risk group) and between the low-risk group and sibs (a high-risk group) ranged from 7 to 19%. The multidimensional neuropsychological indicators revealed may be used for further analysis of genetic risks of schizophrenia.     

Schizophrenia: the systematic construction of genetic models.

Methods are described for the systematic construction of genetic models of schizophrenia with one, two, and four loci. All models are constrained to fit the following three parameters: (1) frequency of schizophrenia in the general population = 0.9%; (2) frequency of schizophrenia in the sibs of schizophrenics = 8%; and (3) frequency of "schizophrenic spectrum" in the sibs of schizophrenics = 15%. In addition, a fourth parameter, the frequency of the allele predisposing to schizophrenia, is freely variable. The problems of correcting for ascertainment bias, and of comparing and testing these genetic models, are discussed.     

Failure to support a genetic contribution of AKT1 polymorphisms and altered AKT signaling in schizophrenia

The protein kinase v-akt murine thymoma viral oncogene homolog (AKT) gene family comprises three human homologs that phosphorylate and inactivate glycogen synthase kinase 3beta (GSK3beta). Studies have reported the genetic association of AKT1 with schizophrenia. Additionally, decreased AKT1 protein expression and the reduced phosphorylation of GSK3beta were reported in this disease, leading to a new theory of attenuated AKT1-GSK3beta signaling in schizophrenia pathogenesis. We have evaluated this theory by performing both genetic and protein expression analyses. A family based association test of AKT1 did not show association with schizophrenia in Japanese subjects. The expression levels of total AKT, AKT1 and phosphorylated GSK3beta detected in the schizophrenic brains from two different brain banks also failed to support the theory. In addition, no attenuated AKT-GSK3beta signaling was observed in the lymphocytes from Japanese schizophrenics, contrasting with previous findings. Importantly, we found that the level of phosphorylated GSK3beta at Ser9 tended to be inversely correlated with postmortem intervals, and that the phosphorylation levels of AKT were inversely correlated with brain pH, issues not assessed in the previous study. These data introduce a note of caution when estimating the phosphorylation levels of GSK3beta and AKT in postmortem brains. Collectively, this study failed to support reduced signaling of the AKT-GSK3beta molecular cascade in schizophrenia.     

Hemispheric Asymmetry in Prosody Perception by Healthy Subjects and Schizophrenic Patients

The interhemispheric interactions in perception of Russian prosody were studied in the norm and in schizophrenia as a clinical model of impaired hemispheric interactions. Monaural presentation of stimuli and binaural presentation in a free acoustical field were used. Sentences with main variants of Russian prosodic intonations were used as stimuli. The response time and the number of erroneous responses were recorded. In binaural listening without headphones, no significant difference in the percent of errors in identifying the emotional prosody was found between healthy subjects and schizophrenics. Compared with the healthy subjects, the patients made more errors in understanding the logical stress and fewer errors in understanding the syntagmatic segmentation. By response time, a significant dominance of the left ear was revealed in the healthy subjects during monaural listening to sentences with emotional prosody and complete or incomplete sentences, whereas no significant ear dominance was found in the schizophrenics. During monaural listening to sentences with logical stress, the response time was shorter when stimuli were presented to the right ear both in the healthy subjects and in the schizophrenics. The results testified that the functional brain asymmetry in schizophrenics is flattened. The flattening was less evident in the perception of a logical stress in a sentence and did not significantly affect the efficiency of identification of emotional prosody and syntagmatic segmentation of a sentence.     

Molecular and Cellular Evidence for an Oligodendrocyte Abnormality in Schizophrenia

Our previous analyses in postmortem prefrontal cortex samples from a well-characterized cohort of severely affected schizophrenics and in matched controls demonstrated decreased expression of myelin and oligodendrocyte-related genes in the disease state. This decreased expression, now replicated in independent studies, suggests that there is a disruption of oligodendrocyte function and/or a loss of oligodendrocytes in schizophrenia. In the current report, we review expression studies in schizophrenia and present data demonstrating consistently fewer oligodendrocytes in schizophrenics compared to controls. The decrease in density reached 22% (p < 0.01) in layer III of area 9 and 20% (p < 0.02) in the white matter of the superior frontal gyrus. These data, when taken together with expression studies carried out by us and by other groups, and by imaging and other microscopic studies, point to a major involvement of oligodendrocyte abnormalities in schizophrenia. Therapies modulating oligodendrocyte survival and differentiation may therefore be beneficial in schizophrenia.     

Increase in serotonin 5-HT1A receptors in prefrontal and temporal cortices of brains from patients with chronic schizophrenia.

Binding studies with [3H]8-hydroxy-2-(di-n-propylamino)tetralin ([3H]8-OH-DPAT), a specific serotonin1A (5-HT1A) receptor agonist, were done on the autopsied brains from control subjects and from patients with chronic schizophrenia. All the patients and controls were of the Japanese race. In the controls, representative Scatchard plots for the specific [3H]8-OH-DPAT bindings in the prefrontal cortex and hippocampus revealed a single component of high affinity binding site (Kd value = 5.7 and 5.9 nM, Bmax value = 80.1 and 101.0 fmol/mg protein, respectively). The [3H]8-OH-DPAT bindings to the prefrontal cortex and hippocampus were potently inhibited by serotonin (IC50 = 6.3 x 10(-9) M) and 5-HT1A agonists (IC50 = 5.0 x 10(-9) - 2.3 x 10(-7) M), while other neurotransmitters, 5-HT2 and 5-HT3 related compounds did not inhibit the binding (IC50 greater than 10(-5) M). The bindings were decreased in the presence of 0.1mM GTP and 0.1mM GppNHp but not in the presence of 0.1mM GMP. In the prefrontal and temporal cortices of schizophrenics, there was a significant increase in the specific [3H]8-OH-DPAT binding, by 40% and 60%, respectively, with no change in the hippocampus, amygdala, cingulum, motor cortex, parietal or occipital cortex, as compared to findings in the controls. Scatchard analysis showed that this increased binding reflects changes in the number of sites but not in the affinity. The effect of 0.1mM GppNHp on the binding to prefrontal cortex was observed in both controls and schizophrenic patients. The bindings were significantly greater in the schizophrenic patients than in controls, in the presence of 0.1mM GppNHp. Our findings suggest that there are GTP-sensitive 5-HT1A sites in the human brain and that selective increases in GTP-sensitive 5-HT1A sites in the prefrontal and temporal cortices of schizophrenics relate to the pathophysiology of schizophrenia.