Effects of acute metabolic stress on the dopaminergic and pituitary-adrenal axis activity in patients with schizotypal personality disorder.
Effects of acute metabolic stress on the dopaminergic and pituitary-adrenal axis activity in patients with schizotypal personality disorder.
复制标题
急性代谢应激对精神分裂型人格障碍患者多巴胺能和垂体-肾上腺轴活动的影响。
DOI：
10.1016/j.schres.2003.10.008
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发表时间：
2004
影响因子：
4.5
通讯作者：
Siever,LarryJ
中科院分区：
文献类型：
--
作者：
Mitropoulou,Vivian;Goodman,Marianne;Sevy,Serge;Elman,Igor;New,AntoniaS;Iskander,ElisabethG;Silverman,JeremyM;Breier,Alan;Siever,LarryJ
背景压力与精神分裂症的发作和精神病症状的恶化有关。患有精神分裂症人格障碍（SPD）（典型的精神分裂症谱系障碍）的患者不会发展出精神分裂症的明显精神病，并且在临床上似乎比精神分裂症患者对压力的反应更小。与健康志愿者 (HV) 相比，精神分裂症患者在服用 2-脱氧葡萄糖 (2-DG)（一种急性代谢（糖尿酸）应激源）后，多巴胺能 (DA) 和下丘脑 - 垂体 - 肾上腺轴 (HPA) 激活增加。我们假设 SPD 患者在 2-DG 与 HV 治疗后会表现出相当或较低的 DA 和 HPA 反应。方法在双盲、安慰剂对照、随机方案中，15 名 SPD 患者和 13 名 HV 接受 2-DG（40 mg/kg，静脉注射）。测定血浆 HVA、ACTH 和皮质醇的曲线下面积 (AUC)（利用基线和输注后指数）。结果 2-DG 导致两组中 ACTH、皮质醇和 HVA 浓度显着增加，并且 SPD 患者的皮质醇升高显着低于 HV 患者。结论 SPD 患者的皮质醇减弱，对 2-DG 的多巴胺能反应正常。这些结果与 SPD 患者在应对压力时能够更好地缓冲 DA 和 HPA 过度激活的假设是一致的。
BackgroundStress has been associated with the onset of schizophrenia and exacerbation of psychotic symptoms. Patients with schizotypal personality disorder (SPD), the prototypic schizophrenia spectrum disorder, do not develop the frank psychosis of schizophrenia and appear clinically to be less reactive to stress than schizophrenic patients. Schizophrenic patients demonstrate increased dopaminergic (DA) and hypothalamic–pituitary–adrenal-axis (HPA) activation following 2-deoxyglucose (2-DG), an acute metabolic (glycopyruvic) stressor, compared to healthy volunteers (HV). We hypothesized that SPD patients would demonstrate comparable or lower DA and HPA responses after 2-DG to HV.MethodsFifteen SPD patients and 13 HV were administered 2-DG (40 mg/kg, i.v.) in a double-blind, placebo-controlled, randomized protocol. The area under the curve (AUC) was determined for plasma HVA, ACTH and cortisol (utilizing baseline and post infusion indices).Results2-DG induced significant increases in ACTH, cortisol and HVA concentrations in both groups and cortisol elevations were significantly lower in patients with SPD than in HV.ConclusionsPatients with SPD have a blunted cortisol and a normal dopaminergic response to 2-DG. These results are consistent with the hypothesis that SPD patients are better buffered against DA and HPA overactivation in response to stress.