精神分裂症自我参照加工受损的认知神经机制

Self-referential processing is the core component of self-awareness and social cognition. Impairments in self- referential processing and related neural networks are relevant to the expression of psychosis. In addition, the performance of self-referential processing can be used to predict the quality of life in schizophrenia. However, little is known about the neuronal substrates underlying self-referential processing abnormalities in schizophrenia. Why the insight of schizophrenia is impaired? Is it related to the impairments of self-referential processing? In clinical diagnosis, bipolar mania is easily confused with schizophrenia as they have similar symptoms, cognitive impairment and etiology. Do patients with bipolar mania also have abnormalities in self-referential processing? Using a simultaneous recording of ERP and fNIRS, we are able to measure the corresponding changes of neural activity and blood oxygen of brain mechanisms for the three hot issues with high time and spatial resolutions in this project. The implementation of this project will help us elucidate the neural mechanisms of the abnormal self-referential processing and the relationship between self abnormality and schizophrenia etiology, and can find the impact factors of insight and the sensitive indicator for the changes of the brain function which is helpful to the diagnosis, intervention and effective evaluation of the mental disorder. The implementation of this project can also provide us with clues to the comparison of the neural mechanism between schizophrenia and bipolar disorder and can help us make diagnosis of these two diseases...

自我参照加工是自我意识和社会认知的核心成分，它的损伤与精神疾病的表达有关，与精神分裂症较差的心理社会结局间存在显著联系。精神分裂症自我参照加工受损的脑机制是什么？精神分裂症自知力的缺损是否与其自我参照加工的异常存在相关？与精神分裂症在症状、认知功能损害及病因学等方面存在交叉，在临床诊断中易与之相混淆的双相情感障碍是否也存在自我参照加工的受损？本项目利用事件相关电位和功能近红外成像联合采集技术，以较高的时间及空间分辨率，从神经电和血氧参数变化两个角度获取自我参照加工的脑功能信息，针对上述三个热点问题展开研究。本项目的顺利实施将有助于精神分裂症自我参照加工受损的脑机制及自我异常和精神分裂症病因关系的阐明；有可能发现自知力损伤的影响因素及脑功能变化的敏感指标，有助于精神分裂症的诊断、干预及疗效评估；可为精神分裂症和双相情感障碍的神经病理机制的比较提供线索，为两者的鉴别诊断提供参考。

自我参照加工是自我意识和社会认知的核心成分，它的损伤与精神疾病的表达有关，与精神分 裂症较差的心理社会结局间存在显著联系。精神分裂症自我参照加工受损的脑机制是什么？精 神分裂症自知力的缺损是否与其自我参照加工的异常存在相关？与精神分裂症在症状、认知功 能损害及病因学等方面存在交叉，在临床诊断中易与之相混淆的双相情感障碍是否也存在自我 参照加工的受损？本项目利用事件相关电位和功能近红外成像联合采集技术，以较高的时间及 空间分辨率，从神经电和血氧参数变化两个角度获取自我参照加工的脑功能信息，针对上述三 个热点问题展开研究. 研究结果发现：精神分裂症和双相情感障碍患者都存在自我参照加工的异常，且用行为学和神经电生理技术手段为其受损的不同模式特征提供了直接的依据。因此，将此应用于对重性精神疾病的鉴别诊断中有可能为不同疾病提供更客观和稳定的鉴别指标，而诊断的明确无论是对于患者的治疗还是康复都具有非常重要的意义。而我们正在进行的近红外数据分析，有可能从空间模式特征的差异角度为这两类疾病的自我参照加工的受损提供依据。对精神分裂症自我参照加工受损的脑功能指标与自知力关系的探讨则有可能发现自知力损伤的脑功能变化的敏感指标，为自知力机制的阐明提供新的视角和途径，为精神分裂症的诊断、干预及疗效评估提供重要依据。