The Study On Cognitive Function P300and Cerebrum Gray Matter Volume Of Schizophrenic In Non-acute Phase

Objective1.To investigate cognitive impairment characteristics in schizophrenic treated with antipsychotic drug but with no satisfying effect (non-acute schizophrenic, following as NAS);2.To explore the relevance between cognitive function and psychiatric symptoms, social function in the NAS;3.To explore the correlation of cerebrum gray matter volume changes and P300of the NAS.Methods1.18non-acute schizophrenic (previous use of antipsychotics, but no satisfying efficacy) and18paired controls were recruited. Auditory event-evoked potential (P300), neuropsychological tests recognized cognitive test battery (MCCB) and additional tests were used to assess cognitive function of subjects. Positive and Negative Syndrome Scale (PANSS) and the Personal and Social Performance (PSP) were used to assess the psychiatric symptoms and social function. To assess antipsychotic medication side effects by the amount of Extrapyramidal Side Effects Scale (ASA), Abnormal Involuntary Movement Scale (AIMS) and Barnes Akathisia Rating Scale (BARS).2. Magnetic Resonance Imaging (MRI)scans were used in patients and controls to obtain the high resolution three-dimensional brain structural images, then the association between P300and gray matter volume(GMV) was analysed.Results1. The NAS showed abnormalities in most items of the neuropsychological test compared with the control group with statistically significant (P<0.05)in trail making test, symbol coding, spatial span, maze, the areas of fluency, emotional management, continued to operate the same pairing (CPT):2-D,3-D,4-D, grooved peg board:handedness and non-handed, space breadth of memory, color connection1and2, category fluency test, the Stroop color word interference test (the Stroop):word, color, color words, auditory continuous addition.2. Compared with control, P300latency of the NAS was shorter(P<0.05) and volatility was not statistically different.3. There were negative correlation between social function and Trail making test A, the color connection test2and the total number of errors of Wisconsin card (-1<r<0). Social function were related to scope of fluent test, the correct number and classification number of Wisconsin card (1> r>0). The P300amplitude was related to the number of Wisconsin Card Sorting (1> r>0). The incubation period may be related to non-sustained error number (r value=0.430, P=0.052).4. Neuropsychological tests and P300have no correlation with psychiatric symptoms of the NAS.5. P300latency was related to part of the brain gray matter volume (right temporal lobe of the superior temporal gyms and middle temporal gyms, right posterior lobe of the cerebellar tonsils, the right cerebellar lobe, the second half of lobular).Conclusions1. There was extensively damage in cognitive function of the NAS, which may be one of the reasons for the poor efficacy of antipsychotics.2. Social function was related to cognitive function of the NAS. Cognitive dysfunction may have significant impact on social function.3. No correlation between P300and psychiatric symptoms, suggesting that cognitive dysfunction may be an independent characteristic pathology.4. Gray matter volume of the NAS in frontal lobe, temporal lobe and cerebellum were different with that of control. P300latency of the NAS were related to gray matter in right temporal lobe of the superior temporal gyms and middle temporal gyrus, right posterior inferior cerebellar leaves, the second half of lobule and right posterior lobe of the tonsils. These areas may be brain structural basis for abnormalities in P300of the NAS. This suggests cognitive dysfunction of the NAS is based on the corresponding pathophysiological processes and brain solid lesion.