■精神病特征在精神分裂症中起重要作用,特别是暴力行为。很少有功能成像研究(fMRI)检查精神分裂症中脑功能障碍对精神病特征的影响。我们的目标是通过功能磁共振成像(fMRI)在精神分裂症的暴力受试者和3个比较组中评估这些特征的神经异常:健康对照(HC),非暴力患者(NV)和非精神病性暴力受试者(NPV)。
■fMRI成像用于测量95名受试者在执行Go/NoGo任务时的血氧水平依赖性激活:26VS,25NPV,26HC,18NVS通过精神病检查表(PCL:SV)的2个因素评估精神病。还评估了受试者的精神症状和教育成就。
■参与反应抑制的脑区的低激活与精神分裂症暴力患者的精神病特征的严重程度有关。这些区域包括额叶区域,扣带皮质,脑岛,precuneus,和基底神经节.对于第一个PCL:SV因子,这种关联非常强,情感人际关系特征,对于第二个PCL:SV因子,反社会冲动的特质。后一种特征也与不良的教育成就有关。
■2种精神病因素具有不同的前因,并且在精神分裂症中在神经水平上是可分离的。脑功能障碍与情感人际关系特征密切相关,而反社会特征与各种因素相关。这对精神分裂症患者暴力的概念化和治疗具有重要意义。
UNASSIGNED: Psychopathic traits play an important role in schizophrenia, particularly for violent behavior. There have been very few functional imaging studies (fMRI) examining the impact of brain dysfunction on psychopathic traits in schizophrenia. Our goal was to evaluate neural abnormalities underlying these traits through fMRI in violent subjects with schizophrenia (VS) and in 3 comparison groups: healthy controls (HC), nonviolent patients (NV), and nonpsychotic violent subjects (NPV).
UNASSIGNED: fMRI imaging was used to measure blood-oxygen-level-dependent activation in 95 subjects while they performed a Go/NoGo task: 26 VS, 25 NPV, 26 HC, and 18 NVS. Psychopathy was evaluated through the 2 factors of the Psychopathy Checklist (PCL:SV). The subjects were also evaluated for psychiatric symptoms and for educational achievement.
UNASSIGNED: Hypoactivation of brain areas involved in response inhibition was related to the severity of psychopathic traits in the violent patients with schizophrenia. These areas included frontal regions, cingulate cortex, insula, precuneus, and basal ganglia. This association was very strong for the first PCL:SV factor, the affective-interpersonal traits, and moderate for the second PCL:SV factor, the antisocial-impulsive traits. The latter traits were also linked to poor educational achievement.
UNASSIGNED: The 2 psychopathic factors have different antecedents and are dissociable at the neural level in schizophrenia. Brain dysfunction is more strongly associated with the affective-interpersonal traits while the antisocial traits are associated with various factors. This has important implications for the conceptualization and treatment of violence in patients with schizophrenia.