State-related changes in cerebral white matter may underlie psychosis exacerbation
State-related changes in cerebral white matter may underlie psychosis exacerbation
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DOI：
10.1016/j.pscychresns.2003.08.002
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发表时间：
2004-01-15
影响因子：
2.3
通讯作者：
Garver, DL
中科院分区：
文献类型：
--
作者：
Christensen, J;Holcomb, J;Garver, DL
先前的报告描述了精神分裂症患者脑白质的加速损失。其他人报告了精神分裂症患者心室容积的变化，其中在精神病症状缓解后增加幅度最大。在这项研究中，测量了 16 名最近失代偿的精神分裂症患者从未使用抗精神病药基线到 4 周后抗精神病药物治疗期间的脑白质体积和精神病症状的变化。还以相似的时间间隔对八个对照组进行了系列白质评估。 16 名患者中有 13 名在治疗期间表现出精神病症状减轻（SAPS 评分降低 24.4 +/- 12.6）。三名患者未能做出反应（SAPS 评分增加 15.7 +/- 13.8）。 4 周期间脑白质的系列体积研究显示，反应者的白质体积减少了 8.2 +/- 8.2 cm(3) (P = 0.003)。未能做出反应的患者在同一时期内白质没有显着增加 11.4 +/- 11.7 cm(3)。 4 周期间白质体积的绝对变化和百分比变化与 SAPS 评分的变化呈正相关（均 P < 0.01）。大脑白质由含有髓磷脂的少突胶质细胞组成，对兴奋性毒性高度敏感。髓磷脂和白质肿胀、对有髓轴突神经传递速度的干扰以及皮质下和皮质网络信息处理的不同步可能与精神病恶化有关。症状的部分缓解可能标志着干扰信息处理的活跃有毒过程的暂时减少。 (C) 2003 Elsevier Ireland Ltd. 保留所有权利。
Previous reports have described accelerated loss of cerebral white matter in schizophrenia. Others have reported changes of ventricle volumes in schizophrenic patients, with greatest increases following remission of psychotic symptoms. In this study changes in cerebral white matter volumes and psychotic symptoms were measured in 16 recently decompensated schizophrenic patients from neuroleptic-free baseline to 4 weeks later during treatment with antipsychotics. Serial white matter assessments were also performed in eight controls at similar intervals. Thirteen of 16 patients showed reduction of psychotic symptoms (reduction of SAPS scores by 24.4 +/- 12.6) during treatment. Three patients failed to respond (increase of SAPS scores by 15.7 +/- 13.8). Serial volumetric studies of cerebral white matter during the 4-week period showed a decrease of white matter volume in the responders by 8.2 +/- 8.2 cm(3) (P = 0.003). Patients who failed to respond showed a non-significant increase in white matter during the same period by 11.4 +/- 11.7 cm(3). Absolute and percentage changes change in white matter volumes during the 4-week period were positively correlated with changes in SAPS scores (both P < 0.01). Cerebral white matter, composed of myelin-containing oligodendrocytes, is highly sensitive to excitotoxicity. Swelling of myelin and of white matter, associated interference with the speed of neurotransmission through myelinated axons, and dyssynchrony of information processing by subcortical and cortical networks may be associated with psychosis exacerbation. Partial remission of symptoms may mark temporary reduction of an active, toxic process that interferes with information processing. (C) 2003 Elsevier Ireland Ltd. All rights reserved.