First- and second-generation antipsychotic medication and cognitive processing in schizophrenia.
First- and second-generation antipsychotic medication and cognitive processing in schizophrenia.
复制标题
第一代和第二代抗精神病药物和精神分裂症的认知处理。
DOI：
10.1007/s11920-005-0085-5
复制
发表时间：
2005
影响因子：
6.7
通讯作者：
Goldberg,TerryE
中科院分区：
文献类型：
--
作者：
Weickert,ThomasW;Goldberg,TerryE
精神分裂症一直以执行功能、工作记忆、注意力和情景记忆等认知领域的缺陷为特征。虽然一些认知异常，如运动减慢，可能与抗精神病药物给药有关，但一般来说，精神分裂症患者表现出的认知缺陷至少部分归因于疾病过程。多巴胺神经递质系统的调节，特别是通过D2受体阻滞，与精神分裂症患者的精神病症状减轻和认知能力改善有关。虽然第一代抗精神病药物治疗最初被认为不会导致认知改善，但最近的研究比较了第二代抗精神病药物与低剂量的第一代抗精神病药物，显示第一代药物的认知益处，尽管可能不如第二代药物治疗后发现的那样大。与抗精神病药物给药相关的认知改善可能是一般皮质信息处理改善的表现。最近的研究表明，特定的遗传多态性可能与抗精神病药物治疗相互作用，影响治疗后认知能力改善的程度。特别是，儿茶酚-O-甲基转移酶val 108/158 met多态性已被证明可以预测精神分裂症患者服用抗精神病药物后工作记忆的改善。
Schizophrenia has been consistently characterized by deficits in the cognitive domains of executive function, working memory, attention, and episodic memory. Although some cognitive abnormalities, such as motor slowing, may be associated with antipsychotic medication administration, generally the cognitive deficits shown by patients with schizophrenia can be attributed at least in part to the disease process. Modulation of the dopamine neurotransmitter system, notably through D2 receptor blockade, has been associated with psychotic symptom reduction and cognitive performance improvements in patients with schizophrenia. Although first-generation antipsychotic medication treatment initially was thought not to result in cognitive improvement, recent studies comparing second-generation antipsychotics to low doses of first-generation antipsychotic medication showed cognitive benefits for first-generation drugs, although perhaps not as great as that found after treatment with second-generation medication. Cognitive improvement associated with administration of antipsychotic medication may be a manifestation of improvement in general cortical information processing. Recent work has shown that specific genetic polymorphisms may interact with antipsychotic medication treatment to influence the degree to which cognitive abilities display improvement after treatment. In particular, the catechol-O-methyltransferase val108/158met polymorphism has been shown to predict working memory improvement after administration of antipsychotic medication to patients with schizophrenia.