ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2019-2-107-118ssmu-2312Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL PAPERSНейрокогнитивный дефицит в клиническом полиморфизме шизофрении: типология, выраженность и синдромальные перекрытияNeurocognitive deficits in clinical polymorphism of schizophrenia: typology, expression and syndromal overlapshttps://orcid.org/0000-0002-2342-7504КорнетовА. Н.KornetovA. N.alkornetov@gmail.comhttps://orcid.org/0000-0002-5179-9727КорнетоваЕ. Г.KornetovaE. G.

Корнетова Елена Георгиевна, д-р мед. наук, вед. науч.сотрудник, отделение ýндогенных расстройств; психиатр-консультант, клиники634050, Томск, Московский тракт, 2

634014, Томск, ул. Алеутская, 4

Kornetova Elena G., DM, Leading Research Officer, Endogenous Disorders Department; Consultant Рsychiatrist

2, Mosсow Trakt, Tomsk, 634050

4, Aleutskaya Str., Tomsk, 634014

ГоленковаА. В.GolenkovaA. V.КозловаС. М.KozlovaS. M.АржаникМ.. Б.ArzhanikM. B.

Arzhanik Marina B., PhD, Associate Professor, Divisionof Physics and Higher Mathematics

2, Mosсow Trakt, Tomsk, 634050

https://orcid.org/0000-0002-7639-1779СамойленкоЖ. А.SamoylenkoZh. A.БойкоА. С.BoikoA. S.https://orcid.org/0000-0002-8698-0251СемкеА. В.SemkeA. V.

Семке Аркадий Валентинович, д-р мед. наук, профессор, зам. директора по научной и лечебной работе,зав. отделением ýндогенных расстройств; профессор, кафедра психиатрии, наркологии, и психотерапии634050, Томск, Московский тракт, 2

634014, Томск, ул. Алеутская, 4

Semke Arkadi V., DM, Professor, Deputy Director for Scientific and Medical Work, Head of the Endogenous Disorders Department; Professor, Division of Psychiatry, Narcology and Psychotherapy2, Mosсow Trakt, Tomsk, 634050

4, Aleutskaya Str., Tomsk, 634014

Сибирский государственный медицинский университет (СибГМУ)РоссияSiberian State Medical University (SSMU)Russian FederationСибирский государственный медицинский университет (СибГМУ); Научно-исследовательский институт (НИИ) психического здоровья, Томский национальный исследовательский медицинский центр (НИМЦ) Российской академии наукРоссияSiberian State Medical University (SSMU); Mental Health Research Institute, Tomsk National Research Medical Center (NRMC) of the Russian Academy of SciencesRussian FederationНаучно-исследовательский институт (НИИ) психического здоровья, Томский национальный исследовательский медицинский центр (НИМЦ) Российской академии наукРоссияMental Health Research Institute, Tomsk National Research Medical Center (NRMC) of the Russian Academy of SciencesRussian Federation201911082019182107118Copyright © Корнетов А.Н., Корнетова Е.Г., Голенкова А.В., Козлова С.М., Аржаник М.Б., Самойленко Ж.А., Бойко А.С., Семке А.В., 20192019Корнетов А.Н., Корнетова Е.Г., Голенкова А.В., Козлова С.М., Аржаник М.Б., Самойленко Ж.А., Бойко А.С., Семке А.В.Kornetov A.N., Kornetova E.G., Golenkova A.V., Kozlova S.M., Arzhanik M.B., Samoylenko Z.A., Boiko A.S., Semke A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/2312

Цель: выявление типологии, выраженности и перекрытия с позитивной и (или) негативной симптоматикой нейрокогнитивных нарушений у пациентов с шизофренией. Материалы и методы. Обследованы 50 пациентов с диагнозом «шизофрения» по ICD-10 в возрасте 22–55 лет (25 женщин (50%) и 25 мужчин (50%)). Средний возраст составил (38,0 ± 4,8) лет, средний возраст манифестации – (23 ± 3,2) года, средняя длительность заболевания – (15 ± 3,7) лет. Пациенты обследованы с помощью батареи тестов для количественной оценки когнитивных функций: тест на зрительно-моторную координацию; тест Струпа; тест беглости  речевых ответов; тест Бентона; заучивание 10 слов; субтест «Шифровка»; субтест «Лабиринты». Оценка когнитивного дефицита проводилась с применением z-шкал. Для выяснения связи нейрокогнитивных нарушений с другими проявлениями клинической картины шизофрении использовалась Шкала позитивных и негативных синдромов. В контрольную группу по показателям когнитивной сферы включены 50 условно здоровых испытуемых из числа добровольцев. Статистическая обработка проводилась с применением непараметрического U-критерия Манна – Уитни, кластерного анализа методом K-средних, H-критерия Краскела – Уоллиса. Результаты. Пациенты с шизофренией и здоровые лица имели значимые различия по тесту Струпа (вторая часть), тесту беглости речевых ответов (обе части), среднему баллу теста Бентона, тесту на заучивание 10 слов (за пять предъявлений), шифровке и лабиринтам с уровнем p < 0,05; по тесту на зрительно-моторную координацию (модификация «B») при p < 0,01. Получен когнитивный профиль выборки, который сопоставлен с показателями PANSS. Обнаружено значимое преобладание выраженности симптоматики по всем ее шкалам при нарушениях внимания, зрительной памяти, исполнительской функции и ориентации и (или) координации по сравнению с остальными проявлениями когнитивного дефицита (p < 0,05). Заключение. Нейрокогнитивный дефицит образует синдромальные перекрытия с позитивными и негативными синдромами шизофрении, а наличие нарушения внимания, зрительной памяти, исполнительской функции и ориентации и (или) координации ассоциировано с тяжестью шизофрении в целом.

Objective. The authors tried to identify the typology, severity and overlap of neurocognitive deficits with positive/negative symptoms in patients with schizophrenia. Materials and methods. Fifty patients aged 22–55 years (25 women (50%) and 25 men (50%)) with schizophrenia diagnosed according to ICD-10 were examined. The average age was 38.0 ± 4.8 years, the average age of onset was 23 ± 3.2 years, the average disease duration was 15 ± 3.7 years. The patients were examined using battery tests to quantify their cognitive functions: Trail Making Test A&B; Stroop Color Word Interference Test; Verbal Fluency; Benton Visual Retention Test; 10 words learning; WAIS Digit Symbol Test; and WAIS Trail Making Test. The evaluation of cognitive deficits was carried out using z-scales. Association of neurocognitive deficits with other schizophrenia symptoms was also estimated using PANSS. The control group that was formed on the basis of the cognitive sphere parameters included 50 healthy volunteers. Statistical processing was carried out using the Mann–Whitney U test, k-means clustering, and the Kruskal-Wallis one-way analysis of variance. Results. The patients with schizophrenia and healthy individuals had significant differences in the second part of the Stroop Color Word Interference Test, both parts of the Verbal Fluency, average score of Benton Visual Retention Test, 10 words learning basedon 5 reiterations, WAIS Digit Symbol Test and WAIS Trail Making Test with p < 0.05; in the Trail Making Test B with p < 0.01. The cognitive sampling profile was determined and compared with the PANSS scores. The significant predominance (p < 0.05) of the symptoms across all scales was found with impaired attention, visual memory, performance function, and/or orientation/coordination, as opposed to the other manifestations of cognitive deficits. Conclusion. Neurocognitive deficits form syndromal overlaps with positive and negative schizophrenia syndromes, and the presence of attention, visual memory, performance and orientation / coordination disturbances is associated with the severity of schizophrenia in general.

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The authors declare that there are no conflicts of interest present.