Reward system activation in schizophrenic patients switched from typical neuroleptics to olanzapine
Reward system activation in schizophrenic patients switched from typical neuroleptics to olanzapine
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DOI：
10.1007/s00213-007-1016-4
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发表时间：
2008-03
影响因子：
3.4
通讯作者：
F. Schlagenhauf;G. Juckel;M. Koslowski;T. Kahnt;Brian Knutson;T. Dembler;T. Kienast;J. Gallinat;J. Wrase;A. Heinz
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文献类型：
--
作者：
F. Schlagenhauf;G. Juckel;M. Koslowski;T. Kahnt;Brian Knutson;T. Dembler;T. Kienast;J. Gallinat;J. Wrase;A. Heinz
多巴胺D2受体在腹侧纹状体（包括中脑核）中的高度阻断可能会干扰奖励预期，并导致继发性阴性症状，如冷漠或快感缺乏。奥氮平等新型精神抑制剂可能并非如此，目的：我们采用功能磁共振成像技术，对服用典型抗精神病药（T1）和改用奥氮平（T2）的精神分裂症患者腹侧纹状体的血氧水平依赖性反应进行了评估。10名精神分裂症患者，在用典型的抗精神病药（T1）和在被转换为奥氮平（T2）后，和10名匹配的健康志愿者参加了金钱激励延迟任务，在其中的视觉线索预测，快速响应随后的目标刺激将导致在金钱上的收益或没有consequence.ResultsDuring奖励的预期，健康志愿者表现出显着较高的腹侧纹状体激活相比，精神分裂症患者与典型的抗精神病药物，但不是奥氮平，这是反映在一个显着的组和会话之间的相互作用。在典型的抗精神病药物治疗的患者，但不与奥氮平，左腹侧纹状体激活减少与阴性symptoms.ConclusionsFailure激活腹侧纹状体在奖励的预期是依赖性的，只观察到在典型的抗精神病药物治疗的患者，但不与奥氮平，这可能表明，这种药物并没有通过干扰奖励预期诱导继发性阴性症状。
RationaleHigh blockade of dopamine D2 receptors in the ventral striatum including the nucleus accumbens may interfere with reward anticipation and cause secondary negative symptoms such as apathy or anhedonia. This may not be the case with newer neuroleptics such as olanzapine, which show less dopamine D2 receptor blockade and a faster off-rate from the receptor.ObjectivesWe used functional magnetic resonance imaging to assess the blood oxygenation level dependent response in the ventral striatum of schizophrenics medicated with typical neuroleptics (T1) and after switching them to olanzapine (T2) and of healthy control subjects at corresponding time points during reward anticipation.Materials and methodsTen schizophrenics, while medicated with typical neuroleptics (T1) and after having been switched to olanzapine (T2), and ten matched healthy volunteers participated in a monetary incentive delay task, in which visual cues predicted that a rapid response to a subsequent target stimulus would either result in monetary gain or have no consequence.ResultsDuring reward anticipation, healthy volunteers showed significantly higher ventral striatal activation compared to schizophrenic patients treated with typical neuroleptics but not olanzapine, which was reflected in a significant interaction between group and session. In patients treated with typical neuroleptics, but not with olanzapine, decreased left ventral striatal activation was correlated with negative symptoms.ConclusionsFailure to activate the ventral striatum during reward anticipation was pharmacologically state-dependent and observed only in patients treated with typical neuroleptics but not with olanzapine, which may indicate that this drug did not induce secondary negative symptoms via interference with reward anticipation.