Increased dopamine transmission in schizophrenia: Relationship to illness phases
Increased dopamine transmission in schizophrenia: Relationship to illness phases
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DOI：
10.1016/s0006-3223(99)00067-0
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发表时间：
1999-07-01
影响因子：
10.6
通讯作者：
Innis, R
中科院分区：
文献类型：
--
作者：
Laruelle, M;Abi-Dargham, A;Innis, R
背景：抗精神病药物具有常见的抗多巴胺能特性，这表明精神分裂症患者存在多巴胺功能异常。然而，鉴于在活体人脑中测量多巴胺传递存在困难，精神分裂症患者存在高多巴胺能状态的直接证据一直难以证明。最近出现了此类证据。三项研究报告称，与匹配的健康对照组相比，精神分裂症患者在接受急性安非他明激发后多巴胺传递增加，从而证明精神分裂症患者存在多巴胺调节异常。在所有研究中，精神分裂症组内这一发现的程度存在较大差异，且无法确定这种效应的临床预测因素。
方法：在本文中，我们结合先前发表的数据和新获取的数据，以获得足够的能力来解决这一问题。
结果：从这个扩展数据集中得出的最重要发现是：1）安非他明激发所揭示的多巴胺功能调节异常在疾病发作时以及从未接触过抗精神病药物的患者中就已存在；2）这种调节异常在病情加重发作的患者中观察到，但在缓解期研究的患者中未观察到。
结论：在精神分裂症的首次发作和后续复发期间存在高多巴胺能状态，但在缓解期不存在。这一发现对缓解期新治疗策略的开发具有重要意义。（C）1999年生物精神病学学会
Background: Abnormalities of dopamine function in schizophrenia are suggested by the common antidopaminergic properties of antipsychotic medications. However, direct evidence of a hyerdopaminergic stare in schizophrenia has been difficult to demonstrate, given the difficulty to measure dopamine transmission in the living human brain, Such evidence has recently emerged. Three studies reported an increase in dopamine transmission following acute amphetamine challenge in patients with schizophrenia compared to matched healthy control subjects, thus demonstrating a dysregulation of dopamine in schizophrenia. In all studies, a large variance was observed within the schizophrenic group in the magnitude of this finding, and clinical predictors of this effect could nor be identified.Methods: In this paper, we combined previously published and newly acquired data to obtain sufficient power to address this question.Results: The most important findings derived from this extended data set are: 1) dysregulation of dopamine function revealed by the amphetamine challenge is present at onset of illness and in patients never previously exposed to neuroleptic medications; 2) this dysregulation was observed in patients experiencing an episode of illness exacerbation, but not in patients studied during a remission phase.Conclusions: A hyperdopaminergic state is present in schizophrenia during the initial episode and subsequent relapses, but not in periods of remission. This finding has important consequences for the development of new treatment strategies for the remission phase. (C) 1999 Society of Biological Psychiatry.