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題名 | 門診慢性精神分裂症之追描眼動異常=Eye Tracking Dysfunction in Chronic Schizophrenic Outpatients |
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作者 | 周裕軒; 楊延光; 黃介良; 蔡子同; 陳純誠; Chou, Yu-hsuan; Yang, Yen-kuang; Huang, Chieh-liang; Tsai, Tze-tung; Chen, Chwen Cheng; |
期刊 | 臺灣精神醫學 |
出版日期 | 19981200 |
卷期 | 12:4 1998.12[民87.12] |
頁次 | 頁13-23 |
分類號 | 415.983 |
語文 | chi |
關鍵詞 | 追描眼動; 精神分裂症; 負性症狀; Eye tracking; Schizophrenia; Negative symptoms; |
中文摘要 | 目的:研究顯示精神分裂症病患的追描眼動表現存在著異質性,但不同追描眼動 表現之病患其臨床特性是否不同則仍未確定,其與精神分裂症症狀的關係仍未有一致結論, 因此本研究擬依三症狀向度(正性、負性、解組性)的概念探討臨床精神分裂症病理症狀與 追描眼動異常的關係。方法:27名正常人和 47 名符合 DSM - Ⅲ - R 精神分裂症診斷的患 者共 74 人參與本研究。所有人均接受平滑追描眼動的檢測並以眼動信號與眼睛位置差總和 的均方根(又稱 RMS error )為追描眼動指標; 同時紀錄病患的個人基本資料與簡短精神 症狀量表、抗精神病藥副作用量表、整體精神狀態評估量表以及注意力測驗等評估項目的得 分。 以叢集分析法 (cluster analysis) 分析患者的 RMS error 分佈情形,再依此分析結 果進一步探討追描眼動指標與臨床變項之相關性及可能意義。結果:實驗組共 47 名病患, 對照組共 27 名個案,男女比分別為 25:22 與 15:12。 實驗組的平均年齡比對照組的平均 年齡小且差異達顯著水準 (p<.001)。實驗組的 RMS error 平均值比對照組大且差異達顯著 水準 (p<.001),此差異不受年齡因素影響 (p<.001)。叢集分析結果顯示病患組之追描眼動 表現可分為高 RMS 與低 RMS 兩組,兩組的 RMS error 平均值差異達顯著水準 (p<.001)。 比較高 RMS 與低 RMS 兩組患者在各臨床變項的差異, 結果顯示低 RMS 組在注意力測驗的 漏劃分數分項、情感淡漠分項與負性症狀等之得分較高 RMS 組低, 且兩組得分之差異達顯 著水準 (p=.04、p=.04, p=.05)。 進一步分析兩組病患負性症狀方面的差異發現:低 RMS 組與高 RMS 組病患症狀表現的差異主要在於 affect 分項的得分。 RMS error 與其他的臨 床病理變項之間未達顯著意義之相關, 但 20 名隨機選出接受 SANS 評估的病患其 RMS error 與情感平淡整體評估、聲調反應貧乏、臉部表情變化及工作與就學中斷程度等四項負 性症狀評分分項之得分達顯著正相關。結論:追描眼動較佳與較差兩組主要差異在於前者呈 現較輕微的負性症狀及較佳的注意力,而病患追描眼動表現愈差,則部份的負性症狀也愈顯 著。本研究的結果支持負性症狀與追描眼動異常相關的推論,尤其是所謂的原發性負性症狀 ,兩者間可能存在共同的病理生理機轉。 |
英文摘要 | Objectives: Eye tracking dysfunction (ETD) may be one of the biological markers of schizophrenia. Studies have shown heterogeneous expression of ETD in schizophrenic patients, and the association between ETD and clinical characteristics is still controversial. Furthermore, no known study to date has explored the relationship between ETD and the three-dimensional model of schizophrenic symptoms. Methods: Twenty seven normal subjects and 47 schizophrenic patients were included. Smooth pursuit eye movements were tested with electro-oculography and the position root mean square (RMS) error was calculated as the eye tracking measure. All patients received evaluations of psychopathology, global functioning, neuroleptic dose and side effect profile, and attention. Cluster analysis was used to examine the heterogeneity of RMS error distribution among patients. Results: Patients were divided into low RMS and high RMS groups according to the results of cluster analysis. The low RMS group had significantly lower mean RMS error score (p<.001), lower omission score on the attention test (p=.038), and lower negative-dimension score (p=.045) than the high RMS group. Further analysis of the Scale for Assessment of Negative Symptoms (SANS) scores showed that the low RMS group had significantly lower scores on the affect subscale than did the high RMS group. The RMS error score was significantly positively correlated with items including global rating of affective flattening (r=.563, p=.01), lack of vocal inflection (r=.548, p=.012), nuchanging facial expression (r=.475, p=.034), and impersistence at work or school (r=.469, p=.037). Conclusion: The results suggest that ETD is more strongly associated with negative symptoms of schizophrenia, especially the so-called primary negative symptoms, than with other symptoms. ETD and negative symptoms may share a common pathophysiology. |
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