Abstract
BackgroundThe cognitive impairment pattern of deficit schizophrenia (DS) is centered on an impaired attention function. Previous studies have suggested that the exploratory eye movement (EEM) tests reflect attention deficits in patients with schizophrenia. However, no study has investigated the characteristics of eye movement in DS in the Chinese Han population. This study aimed to investigate the pattern of eye movement characteristics in DS patients and to examine whether eye movement characteristic is associated with serious negative symptoms and cognitive decline in this schizophrenia subtype.MethodsA total of 86 male patients [37 DS and 49 non-deficit schizophrenia (NDS)] and 80 healthy controls (HC) participated in this study. Clinical symptoms were assessed using the Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS). Cognitive function was assessed using the Mattis Dementia Rating Scale (MDRS-2). Eye movement data of subjects were collected using an eye movement tracking analyzer.ResultsThere were significant differences in the overall eye movement data and cognitive test scores among the three groups (all P < 0.001). Both DS and NDS schizophrenia subgroups showed more severe eye movement and cognitive impairment compared with the control group. The number of eye fixations (NEF), total of eye scanning length (TESL), and cognitive function in DS patients were significantly lower than those in NDS patients. The discriminant analysis (D score) was higher than that of the control group (P < 0.001). In the DS group, the inattention factor of SANS was negatively correlated with the attention factor (r = − 0.545, P = 0.001) and structure factor of cognitive (r = − 0.389, P = 0.023), the affective flattening factor of SANS was negatively correlated with TESL (r = − 0.353, P = 0.041) and initiation/retention factor of cognitive (r = − 0.376,P = 0.028). TESL was found to positively correlate with the MDRS-2 total score (r = 0.427, P = 0.012), attention factor (r = 0.354, P = 0.040), and memory factor (r = 0.349, P = 0.043) in the DS group, whereas the mean of eye scanning length (MESL) positively correlated with cognitive impairments in the NDS group. The negative symptoms showed no significant correlation with cognition in the NDS group.ConclusionsTotal of eye scanning length may be a characteristic eye movement symptom in DS patients, which is associated with serious negative symptoms and cognitive impairment in this schizophrenia subtype.
Highlights
Schizophrenia is a common and severe mental disease in clinical practice, which leads to social dysfunction [1], and might be the most disabling of all mental disorders [2]
Our results indicated that significant differences in family history (P < 0.001) and marital status (P < 0.001) among the three groups, but the two patient subgroups had no significant differences in terms of family history (P = 0.209), marital status (P = 0.754), the mean age at onset, smoking status, positive symptoms, and antipsychotic medicine dosage, except for duration of disease (t = 3.771, P < 0.001) in the deficit schizophrenia (DS) group
As the family history and marital status varied among the healthy controls (HC) subjects, DS and non-deficit schizophrenia (NDS) patients, we further made a stratification by the family history and marital status to compare the cognitive function among these three groups, the results showed in the Additional file 1: Table S1 and Table S2
Summary
Schizophrenia is a common and severe mental disease in clinical practice, which leads to social dysfunction [1], and might be the most disabling of all mental disorders [2]. The treatment of schizophrenia has made considerable progress, but about one-third of patients still have an unfavorable prognosis and continue to show decline in social functioning [5]. The cognitive impairment pattern in DS is centered on the impaired attention function [7]. DS patients are characterized by familial aggregation, high birth rate in summer, poor long-term clinical efficacy, and early decline in social function [8, 9]. The cognitive impairment pattern of deficit schizophrenia (DS) is centered on an impaired attention function. Previous studies have suggested that the exploratory eye movement (EEM) tests reflect attention deficits in patients with schizophrenia. This study aimed to investigate the pattern of eye movement characteristics in DS patients and to examine whether eye movement characteristic is associated with serious negative symptoms and cognitive decline in this schizophrenia subtype
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