Effect of a haloperidol challenge on regional brain metabolism in neuroleptic-responsive and nonresponsive schizophrenic patients
Effect of a haloperidol challenge on regional brain metabolism in neuroleptic-responsive and nonresponsive schizophrenic patients
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DOI：
10.1176/ajp.155.3.337
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发表时间：
1998-03-01
影响因子：
17.7
通讯作者：
Schiffer, W
中科院分区：
文献类型：
--
作者：
Bartlett, EJ;Brodie, JD;Schiffer, W
目的：测量治疗有反应和无反应的精神分裂症患者对精神安定药物激发的中枢神经系统代谢反应，以检查治疗结果与响应急性受体阻断而改变神经化学功能的能力之间的关系。方法：使用正电子发射断层扫描（PET）和[F-18]氟脱氧葡萄糖（FDG）测量七名先前被认为对药物治疗有反应的精神分裂症患者和七名在至少3周（基线）无药物治疗期后以及给予5.0 mg氟哌啶醇后12小时后无反应的精神分裂症患者的局部脑代谢。结果：氟哌啶醇激发导致无反应患者的绝对代谢广泛下降，但没有反应的患者。这些组间差异反映了第二次（挑战）扫描的结果，因为两组的基线代谢值没有统计学差异。氟哌啶醇攻击后无反应者代谢活动降低的模式与之前在正常受试者中观察到的相似。结论：对药物挑战的代谢反应将治疗反应者与无反应者和正常受试者区分开来。结果表明，精神分裂症（和其他精神疾病）的亚型可以通过使用化学脑成像技术测量体内对药理学挑战的生理反应来实现。
Objective: The CNS metabolic response to a neuroleptic challenge in treatment-responsive and nonresponsive schizophrenic patients was measured in order to examine the relation between treatment outcome and the capacity to alter neurochemical function in response to acute receptor blockade. Method: Positron emission tomography (PET) and [F-18]fluorodeoxyglucose (FDG) were used to measure regional cerebral metabolism in seven schizophrenic patients judged to have been responsive to drug treatment previously and seven nonresponsive schizophrenic patients after a drug-free period of at least 3 weeks (baseline) and again 12 hours after administration of 5.0 mg of haloperidol. Results: The haloperidol challenge caused widespread decreases in absolute metabolism in the nonresponsive patients but not the responsive patients. These group differences reflect the findings on the second (challenge) scans, since metabolic values at baseline were not statistically different in the two groups. The pattern of decreased metabolic activity in the nonresponders after the haloperidol challenge is similar to that previously observed in normal subjects. Conclusions: The metabolic response to drug challenge separates treatment responders from nonresponders and normal subjects. The results suggest that subtyping of schizophrenia (and other psychiatric disorders) can be achieved by measuring the physiologic response to a pharmacologic challenge in vivo with chemical brain-imaging techniques.