Prefrontal and Striatal Gamma-Aminobutyric Acid Levels and the Effect of Antipsychotic Treatment in First-Episode Psychosis Patients.
Prefrontal and Striatal Gamma-Aminobutyric Acid Levels and the Effect of Antipsychotic Treatment in First-Episode Psychosis Patients.
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DOI：
10.1016/j.biopsych.2017.09.028
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发表时间：
2018-03-15
影响因子：
10.6
通讯作者：
Shungu DC
中科院分区：
文献类型：
--
作者：
de la Fuente-Sandoval C;Reyes-Madrigal F;Mao X;León-Ortiz P;Rodríguez-Mayoral O;Jung-Cook H;Solís-Vivanco R;Graff-Guerrero A;Shungu DC
据报道，在未使用抗精神病药物的精神分裂症患者中，内侧前额叶皮质（MPFC）中的γ-氨基丁酸（GABA）水平异常升高。这种GABA升高是否也存在于其他脑区，并在抗精神病药物治疗后持续存在，以前尚未研究。28名未接受抗精神病药物治疗的首发精神病（FEP）患者和18名健康对照受试者完成了研究。在靶向MPFC和第二区域（背尾状核）的基线质子磁共振波谱扫描后，FEP患者接受口服利培酮治疗4周，初始剂量为1 mg/天，根据临床判断根据需要滴定。4周治疗期后，两组患者均返回接受结果MRS扫描，与基线时进行的扫描相同。在基线时，较高的GABA水平被发现在MPFC和FEP患者的背尾状体比健康对照组。抗精神病药物治疗4周后，FEP患者MPFC中GABA水平相对于基线降低，而背尾状核中仅在相对于基线的趋势水平下降低。对于任何一个大脑区域，在4周或治疗后的GABA水平在FEP患者和健康对照受试者之间没有差异。本研究的结果记录了GABA水平的升高，在MPFC和首次，在抗精神病药初治FEP患者的背尾状核，这两个地区正常化后4周的抗精神病药物治疗。
Abnormally elevated levels of γ-aminobutyric acid (GABA) in the medial prefrontal cortex (MPFC) have been reported in antipsychotic-free patients with schizophrenia. Whether such GABA elevations are also present in other brain regions and persist after antipsychotic treatment has not been previously investigated. Twenty-eight antipsychotic-naive first-episode psychosis (FEP) patients and 18 healthy control subjects completed the study. Following baseline proton magnetic resonance spectroscopy scans targeting the MPFC and a second region, the dorsal caudate, FEP patients were treated with oral risperidone for 4 weeks, at an initial dose of 1mg/day that was titrated as necessary based on clinical judgment. After the 4-week treatment period, both groups were brought back to undergo outcome MRS scans, which were identical to the scans conducted at baseline. At baseline, higher GABA levels were found both in the MPFC and in the dorsal caudate of FEP patients than in healthy control subjects. Following 4 weeks of antipsychotic treatment, GABA levels in FEP patients decreased relative to baseline in the MPFC, while decreasing only at the trend-level relative to baseline in the dorsal caudate. For either brain region, GABA levels at 4 weeks or post-treatment did not differ between FEP patients and healthy control subjects. The results of the present study have documented elevations of GABA levels in both the MPFC and, for the first time, in the dorsal caudate of antipsychotic-naive FEP patients, which normalized in both regions following 4 weeks of antipsychotic treatment.
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DOI：
10.1016/j.nicl.2014.10.005
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期刊：
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