Diminished plasma oxytocin in schizophrenic patients with neuroendocrine dysfunction and emotional deficits
Diminished plasma oxytocin in schizophrenic patients with neuroendocrine dysfunction and emotional deficits
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DOI：
10.1016/j.schres.2007.09.019
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发表时间：
2008-01-01
影响因子：
4.5
通讯作者：
Carter, C. S.
中科院分区：
文献类型：
--
作者：
Goldman, Morris;Marlow-O'Connor, Megan;Carter, C. S.
多容性低钠血症性精神分裂症患者（PHS）表现出血浆精氨酸抗利尿激素（pAVP）和下丘脑垂体-肾上腺（HPA）轴对应激的增强反应，这似乎可归因于海马前部功能障碍。神经解剖学和电生理学研究表明，PHS患者的催产素活性也应受到影响。此外，催产素通常会降低HPA对压力的反应，并促进精神分裂症患者的认知和行为功能受损，这表明催产素活性的降低可能会导致这一亚群的神经精神障碍。在本研究中，我们测量了6例多饮性低钠血症（PHS）、4例多饮性正常钠血症（PNS）、5例非多饮性正常钠血症精神分裂症（NNS）患者和7例健康对照者应激诱导前后的血浆催产素水平。这些受试者中的大多数还完成了测量他们内侧颞叶体积、海马体介导的HPA反馈和区分不同面部情绪的能力（一种对催产素敏感的测量，在精神分裂症中明显受损）的研究。结果表明：1)低钠血症患者血浆催产素水平较其他三组低（p= 0.006），且两组水平相近，无明显变化。所有受试者的催产素水平2)与海马前部呈负相关（p= 0.004）（但与海马后部或杏仁核体积无关），3)与海马介导的HPA反馈完整性直接相关（p= 0.039）。最后，催产素水平预测了精神分裂症患者正确识别面部情绪的能力（p= 0.004）。这些初步数据提供了进一步的证据，证明小灵通的神经内分泌功能障碍反映了海马前部病理，并有助于特征性的神经精神综合征。(C) 2007 Elsevier B.V.版权所有
Polydipsic hyponatremic schizophrenic patients (PHS) exhibit enhanced plasma arginine vasopressin (pAVP) and hypothalamic pituitary adrenal (HPA) axis responses to stress that appear attributable to anterior hippocampal dysfunction. Neuroanatomic, and electrophysiologic studies indicate oxytocin activity in PHS patients should also be affected. Furthermore, oxytocin normally diminishes HPA responses to stress and facilitates cognitive and behavioral functions impaired in schizophrenia, suggesting that diminished oxytocin activity could contribute to this subsets' neuropsychiatric disorder. In the present study, we measured plasma oxytocin levels at intervals before and after stress induction in six polydipsic hyponatremic (PHS), four polydipsic normonatremic (PNS), five nonpolydipsic normonatremic schizophrenic (NNS) patients and seven healthy controls. Most of these subjects also completed studies measuring their medial temporal lobe volumes, their hippocampal-mediated HPA feedback and their ability to discriminate different facial emotions (an oxytocin-sensitive measure which is markedly impaired in schizophrenia). Results demonstrated that 1) plasma oxytocin levels were lower (p=.006) in hyponatremic patients relative to the other three groups, whose levels were similar and did riot change. Oxytocin levels across all subjects were 2) inversely correlated with anterior hippocampal (p=.004) (but not posterior hippocampal or amygdala volumes), and 3) directly correlated with the integrity of hippocampal-mediated HPA feedback (p=.039). Finally, 4) oxytocin levels predicted schizophrenic patients' ability to correctly identify facial emotions (p=.004). These preliminary data provide further evidence that neuroendocrine dysfunction in PHS reflects anterior hippocampal pathology and contributes to a characteristic neuropsychiatric syndrome. (C) 2007 Elsevier B.V. All rights reserved.