精神分裂症患者基于规则和信息整合类别学习
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摘要
有大量来自认知神经科学、神经心理学和行为学方面的证据支持着类别学习的多重系统理论。前人的研究显示：基于规则类别学习主要依靠的脑区域为左侧颞叶,而依赖于非言语的信息整合类别学习主要依靠的脑区域为后尾状核。前额叶皮层和颞叶内侧这些脑结构是精神分裂症患者重要的病理结构。由于前额叶和颞叶内侧受损,精神分裂症患者在认知功能上大多数表现为外显的陈述性学习受损；而由于患者的疾病严重程度和患者服用的药物类型在不同程度上影响了纹状体功能,从而使得患者在内隐学习上的表现也存在了分歧。而且纹状体是支持信息整合类别学习的关键脑结构。所以,可以通过探讨精神分裂症患者信息整合类别学习是否受损,而进一步证明信息整合类别学习依靠的脑区域为纹状体结构。本研究是首次对精神分裂症患者基于规则和信息整合类别学习进行探讨研究的,这是本研究的创新点之一。
所以在本研究中,同时探查精神分裂症患者在基于规则和信息整合类别学习中的表现。考察精神分裂症患者基于规则和信息整合类别学习的表现是否有差异；服用经典抗精神病药物与服用非经典抗精神病药物的患者间两种类别学习是否存在差异。以上就是本研究所要考察的内容。
研究选取健康对照组20人,不患有其他神经系统疾病的精神分裂症患者40名,要求他们完成基于规则和信息整合两项类别学习任务。在患者组,其中18名患者服用经典抗精神病药物,22名患者服用非经典抗精神病药物。在两个任务中,要求被试对任务中的刺激进行分类。为了避免两个任务间的干扰,两个任务被安排在隔天进行。任务按照ABBA的顺序进行以消除顺序效应。
实验结果显示：在基于规则类别学习任务中,正常对照组被试成绩明显优于病人组,且服用经典抗精神病药物患者与服用非经典抗精神病药物的患者表现无差异；在信息整合类别学习任务中,非经典抗精神病药物精神分裂症患者信息整合类别学习成绩显著高于服用经典抗精神病药物患者的成绩；而与正常对照组信息整合类别学习成绩差异不显著。
综合实验结果可以得出以下结论,精神分裂症患者在基于规则和信息整合两种类别学习任务表现上相分离,支持类别学习多系统理论；经典抗精神病药物通过抑制纹状体多巴胺D2受体而影响精神分裂症患者信息整合类别学习的表现。
A substantial and growing body of evidence from functional neuroimaging, neuropsychological and behavioral studies support the concept of multiple category learning systems. Previous research revealed that successful rule-based (RB) categorization depend on the medial temporal lobe and non-verbalizable information-integration (Ⅱ) category learning depend on the posterior caudate selectively. These structures, which are prefrontal cortex and medial temporal lobe, are critical in the pathophysiology of schizophrenia. Because of the impairs of prefrontal cortex and medial temporal lobe, schizophrenia seems to be impaired performance on most tests of explicit or declarative learning. However, owning to the striatum which was influenced by the stage of their illness and antipsychotics, the schizophrenia displayed different performance. So there have been conflicting results for implicit learning in schizophrenia. And the striatum was the critical brain structures of information-integration category learning. The studies investigating the cognitive of schizophrenia with rule-based and information-integration category learning could add to growing evidence that information-integration category learning depend on the striatum. The present study, was the first study investigating the cognitive of schizophrenia with rule-based and information-integration category learning, which was one of the the innovation.
Thus it raised two questions that whether the performance in schizophrenia varies on the rule-based and information-integration categorization and whether the first-generation drugs affect the performance on information-integration categorization. This research was designed to throw some light on these questions.
20 health control partitions, and 40 patients with schizophrenia, who didn't be suffered from other nervous system diseases, were asked to complete both rule-based tasks and information-integration tasks based on feedback. In patients groups, there are 18 patients taking the first-generation drugs and 22 other patients taking the second-generation drugs. In two tasks, the participants were asked to learn to put all materials into two categories. To avoid the influence between two tasks, two tasks were completed in every other day. The order of two tasks was ordered with ABBA to avoid the order effect.
The results showed that:in rule-based tasks, the health control group preformed significantly higher accuracy than the patients group, and the patients receiving first-generation drugs didn't exhibit significantly differently from those receiving second-generation drugs. However, in information-integration category learning, the patients receiving first-generation drugs preformed significantly higher accuracy than those receiving second-generation drugs, but didn't exhibit significantly differently from the health control group.
In conclusion, the present findings indicated that two category learning tasks were mediated by functionally separate systems. Besides, the first generation antipsychotics may disrupt information-integration category learning depending on inhibiting dopamine D2 receptors in the striatum.
所以在本研究中,同时探查精神分裂症患者在基于规则和信息整合类别学习中的表现。考察精神分裂症患者基于规则和信息整合类别学习的表现是否有差异；服用经典抗精神病药物与服用非经典抗精神病药物的患者间两种类别学习是否存在差异。以上就是本研究所要考察的内容。
研究选取健康对照组20人,不患有其他神经系统疾病的精神分裂症患者40名,要求他们完成基于规则和信息整合两项类别学习任务。在患者组,其中18名患者服用经典抗精神病药物,22名患者服用非经典抗精神病药物。在两个任务中,要求被试对任务中的刺激进行分类。为了避免两个任务间的干扰,两个任务被安排在隔天进行。任务按照ABBA的顺序进行以消除顺序效应。
实验结果显示：在基于规则类别学习任务中,正常对照组被试成绩明显优于病人组,且服用经典抗精神病药物患者与服用非经典抗精神病药物的患者表现无差异；在信息整合类别学习任务中,非经典抗精神病药物精神分裂症患者信息整合类别学习成绩显著高于服用经典抗精神病药物患者的成绩；而与正常对照组信息整合类别学习成绩差异不显著。
综合实验结果可以得出以下结论,精神分裂症患者在基于规则和信息整合两种类别学习任务表现上相分离,支持类别学习多系统理论；经典抗精神病药物通过抑制纹状体多巴胺D2受体而影响精神分裂症患者信息整合类别学习的表现。
A substantial and growing body of evidence from functional neuroimaging, neuropsychological and behavioral studies support the concept of multiple category learning systems. Previous research revealed that successful rule-based (RB) categorization depend on the medial temporal lobe and non-verbalizable information-integration (Ⅱ) category learning depend on the posterior caudate selectively. These structures, which are prefrontal cortex and medial temporal lobe, are critical in the pathophysiology of schizophrenia. Because of the impairs of prefrontal cortex and medial temporal lobe, schizophrenia seems to be impaired performance on most tests of explicit or declarative learning. However, owning to the striatum which was influenced by the stage of their illness and antipsychotics, the schizophrenia displayed different performance. So there have been conflicting results for implicit learning in schizophrenia. And the striatum was the critical brain structures of information-integration category learning. The studies investigating the cognitive of schizophrenia with rule-based and information-integration category learning could add to growing evidence that information-integration category learning depend on the striatum. The present study, was the first study investigating the cognitive of schizophrenia with rule-based and information-integration category learning, which was one of the the innovation.
Thus it raised two questions that whether the performance in schizophrenia varies on the rule-based and information-integration categorization and whether the first-generation drugs affect the performance on information-integration categorization. This research was designed to throw some light on these questions.
20 health control partitions, and 40 patients with schizophrenia, who didn't be suffered from other nervous system diseases, were asked to complete both rule-based tasks and information-integration tasks based on feedback. In patients groups, there are 18 patients taking the first-generation drugs and 22 other patients taking the second-generation drugs. In two tasks, the participants were asked to learn to put all materials into two categories. To avoid the influence between two tasks, two tasks were completed in every other day. The order of two tasks was ordered with ABBA to avoid the order effect.
The results showed that:in rule-based tasks, the health control group preformed significantly higher accuracy than the patients group, and the patients receiving first-generation drugs didn't exhibit significantly differently from those receiving second-generation drugs. However, in information-integration category learning, the patients receiving first-generation drugs preformed significantly higher accuracy than those receiving second-generation drugs, but didn't exhibit significantly differently from the health control group.
In conclusion, the present findings indicated that two category learning tasks were mediated by functionally separate systems. Besides, the first generation antipsychotics may disrupt information-integration category learning depending on inhibiting dopamine D2 receptors in the striatum.
引文
高永利,刘小彩,杨来启,何江萍,邓自和.(2005).精神分裂症动物模型学习记忆实验研究[J].中国行为医学科学,14(8),684-686.
郭新宇.(2010).精神分裂症患者认知功能研究[J].临床精神医学杂志,20(3),208-210.
李欣馨,徐成敏,张天亮.(2009).抗精神病药与精神分裂症患者认知功能的相关性研究进展[J].精神医学杂志,22(3),234-236.
林淑香.(2010).稳定期精神分裂症认知功能及相关因素[J].中国民康医学,22(5),540-541.
刘万伦.(2007).分类任务难度对两种类别学习影响的实验研究[D].博士研究生学位论文.辽宁.辽宁师范大学教育学院.
刘万伦,张奇.(2008).类别学习的神经心理学研究[J].心理科学进展,16,36-41.
马继东,于文斗,潘赞.(2010).首发精神分裂症患者认知功能的研究[J].中国民康医学,22(5),526-527.
沈婷,黄继忠.(2010).精神分裂症、抑郁症的认知功能障碍研究进展[J].国际精神病学杂志,37(2),123-126.
肖晓杨,谭小林,林晖,傅义容,徐琳.(2010).抗精神病药治疗对稳定期精神分裂症患者认知功能的影响[J].重庆医学,39(4),438-441.
杨桂芬,张权,张云亭,沈建华,张新军,陈清刚.(2009).精神分裂症患者工作记忆不同认知成分的fMRI研究[J].中国临床医学影像杂志,20(10),785-761.
姚静,郭兰婷,孙锦华,周为,王强,马小红等.(2006).精神分裂症高危人群认知功能研究[J].中国循证医学杂,6,563-566.
杨绪娜,朱峰,李乐华.(2010).非典型抗精神病药对精神分裂症认知功能影响的研究进展[J].国际精神病学杂志,37(3),167-171.
张毅,陈美娟,徐斐康,沈辉,钱竹书,王佩青,等.(2010).抗精神病药对精神分裂症患者认知功能的影响[J].临床精神医学杂志20(1),23-25
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Beninger RJ, Wasserman J, Zanibbi K, Charbonneau D, Mangels J,& Beninger BV. (2003). Typical and atypical antipsychotic medications differentially affect two nondeclarative memory tasks in schizophrenic patients:a double dissociation[J]. Schizophrenia research,61,281-292.
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李欣馨,徐成敏,张天亮.(2009).抗精神病药与精神分裂症患者认知功能的相关性研究进展[J].精神医学杂志,22(3),234-236.
林淑香.(2010).稳定期精神分裂症认知功能及相关因素[J].中国民康医学,22(5),540-541.
刘万伦.(2007).分类任务难度对两种类别学习影响的实验研究[D].博士研究生学位论文.辽宁.辽宁师范大学教育学院.
刘万伦,张奇.(2008).类别学习的神经心理学研究[J].心理科学进展,16,36-41.
马继东,于文斗,潘赞.(2010).首发精神分裂症患者认知功能的研究[J].中国民康医学,22(5),526-527.
沈婷,黄继忠.(2010).精神分裂症、抑郁症的认知功能障碍研究进展[J].国际精神病学杂志,37(2),123-126.
肖晓杨,谭小林,林晖,傅义容,徐琳.(2010).抗精神病药治疗对稳定期精神分裂症患者认知功能的影响[J].重庆医学,39(4),438-441.
杨桂芬,张权,张云亭,沈建华,张新军,陈清刚.(2009).精神分裂症患者工作记忆不同认知成分的fMRI研究[J].中国临床医学影像杂志,20(10),785-761.
姚静,郭兰婷,孙锦华,周为,王强,马小红等.(2006).精神分裂症高危人群认知功能研究[J].中国循证医学杂,6,563-566.
杨绪娜,朱峰,李乐华.(2010).非典型抗精神病药对精神分裂症认知功能影响的研究进展[J].国际精神病学杂志,37(3),167-171.
张毅,陈美娟,徐斐康,沈辉,钱竹书,王佩青,等.(2010).抗精神病药对精神分裂症患者认知功能的影响[J].临床精神医学杂志20(1),23-25
Ashby FG,& Gott RE.(1988). Deci sion rules in the perception and categorization of multidimensional stimuli[J].Exp.Psychol.:Learn. Mem.Cogn,14:33-53.
Ashby FG, Alfonso-Reese LA, Turken AU,& Waldron EM. (1998). A neuropsychological theory of multiple systems in category learning[J]. Psychological Review,105,442-481.
Ashby FG., Queller, S., Berretty, PM., (1999). On the dominance of unidimensional rules in unsupervised categorization[J]. Perception & Psychophysics,61,1178-1199.
Ashby FG, Noble S, Filoteo JV, Waldron EM,& Ell SW. (2003). Category learning deficits in Parkinson's disease[J]. Neuropsychology,17, 115-124.
Ashby FG,& Maddox WT. (2005). Human category learning[J]. Annual Reviews,56,150-162.
Beninger RJ, Wasserman J, Zanibbi K, Charbonneau D, Mangels J,& Beninger BV. (2003). Typical and atypical antipsychotic medications differentially affect two nondeclarative memory tasks in schizophrenic patients:a double dissociation[J]. Schizophrenia research,61,281-292.
Cinctta CM,& Seger CA. (2007). Dissociation between striatal regions while learning to category via feedback and observation[J]. Journal of Cognitive Neuroscience,19,249-265.
Danion J. M., Meulemans T., Kauffmann-Muller F.,& Vermaat H. (2001) Intact implicit learning in schizophrenia [J]. American Journal of Psychiatry,158(6):944-948.
Exner C, Boucsein K, Degner D,& Irle E. (2006). State-dependent implicit learning deficit in schizophrenia:Evidence from 20-month follow-up[J]. Psychiatry Research,142,39-52.
Filoteo JV, Maddox WT,& Davis JD. (2001). A possible role of the striatum in linear and nonlinear category learning:evidence from patients with Huntington's Disease[J]. Behavioral Neuroscience,115, 786-798.
Filoteo JV, Maddox WT, Ing AD,& Song DD. (2007). Characterizing rule-based category learning deficits in patients with Parkinson's disease[J]. Neuropsychologia,45,305-320.
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