简介:精神分裂症患者的电生理(EEG)异常已得到大量报道。在过去的几十年里,研究已经转向识别疾病的前驱和早期阶段的电生理改变,重点是临床和功能结果的预测。识别首次发作精神病(FEP)的受试者和处于超高风险(UHR)或临床高风险(CHR)的受试者的神经元畸变对于实施适当的干预措施至关重要。降低向精神病过渡的速度,以及不可逆功能损害的风险。这篇综述的目的是提供精神分裂症处于危险状态和早期阶段的电生理发现的最新综合。方法:使用Pubmed,Scopus,PsychINFO于2020年7月进行。通过手工搜索确定了其他研究。包括至少一组FEP或有精神病风险的受试者的电生理研究,与健康对照(HC)相比,被考虑。研究的异质性阻碍了定量合成。结果:在筛查的319条记录中,133项研究包括在最终的定性合成中。纳入的研究主要采用频率分析,微状态和事件相关电位。最常见的发现包括δ和伽马功率的增加,通过P50和N100评估的感觉门控受损,以及在有风险的精神状态和精神分裂症早期阶段中不匹配阴性和P300振幅的降低。其中一些电生理措施的逐步变化与向精神病和疾病进程的过渡有关。已经报告了用于评估同步性的指标的异构数据,连通性,以及不同频段的诱发反应。结论:在精神分裂症的危险精神状态和早期阶段,多种脑电图指标发生了变化,支持大脑网络功能障碍在疾病发作之前就已经出现的假设。这些改变中的一些证明与向精神病的转变或不良的功能结果有关。然而,受试者纳入标准的异质性,临床措施和电生理方法无法得出可靠的结论。需要大型前瞻性研究来巩固有关临床和功能结果的电生理标志物的发现。
Introduction: Electrophysiological (EEG) abnormalities in subjects with schizophrenia have been largely reported. In the last decades, research has shifted to the identification of electrophysiological alterations in the prodromal and early phases of the disorder, focusing on the prediction of clinical and functional outcome. The identification of neuronal aberrations in subjects with a first episode of psychosis (FEP) and in those at ultra high-risk (UHR) or clinical high-risk (CHR) to develop a psychosis is crucial to implement adequate interventions, reduce the rate of transition to psychosis, as well as the risk of irreversible functioning impairment. The aim of the
review is to provide an up-to-date synthesis of the electrophysiological findings in the at-risk mental state and early stages of schizophrenia. Methods: A systematic
review of English articles using Pubmed, Scopus, and PsychINFO was undertaken in July 2020. Additional studies were identified by hand-search. Electrophysiological studies that included at least one group of FEP or subjects at risk to develop psychosis, compared to healthy controls (HCs), were considered. The heterogeneity of the studies prevented a quantitative synthesis. Results: Out of 319 records screened, 133 studies were included in a final qualitative synthesis. Included studies were mainly carried out using frequency analysis,
microstates and event-related potentials. The most common findings included an increase in delta and gamma power, an impairment in sensory gating assessed through P50 and N100 and a reduction of Mismatch Negativity and P300 amplitude in at-risk mental state and early stages of schizophrenia. Progressive changes in some of these electrophysiological measures were associated with transition to psychosis and disease course. Heterogeneous data have been reported for indices evaluating synchrony, connectivity, and evoked-responses in different frequency bands. Conclusions: Multiple EEG-indices were altered during at-risk mental state and early stages of schizophrenia, supporting the hypothesis that cerebral network dysfunctions appear already before the onset of the disorder. Some of these alterations demonstrated association with transition to psychosis or poor functional outcome. However, heterogeneity in subjects\' inclusion criteria, clinical measures and electrophysiological methods prevents drawing solid conclusions. Large prospective studies are needed to consolidate findings concerning electrophysiological markers of clinical and functional outcome.