Representativeness of clinical PET study participants with schizophrenia: a systematic review
Representativeness of clinical PET study participants with schizophrenia: a systematic review
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精神分裂症临床 PET 研究参与者的代表性：系统评价
DOI：
10.1016/j.jpsychires.2016.12.023
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发表时间：
2017
期刊：
影响因子：
4.8
通讯作者：
Uchida H
中科院分区：
文献类型：
--
作者：
Kirino S;Suzuki T;Takeuchi H;Mimura M;Uchida H
虽然正电子发射断层扫描（PET）研究提供了抗精神病药作用的宝贵数据，但选择偏倚仍然是一个严重问题。使用 PubMed、EMBASE 和 ClinicalTrials.gov（最后一次检索，2016 年 9 月）对测量抗精神病药物多巴胺 D2 受体阻断作用的 PET 研究进行系统回顾，以检查其纳入/排除标准。如果 PET 研究测量了精神分裂症患者 D2 受体的占用情况，并包括系统地引入抗精神病药物治疗或改变抗精神病药物治疗方案，则纳入其中。确定了 26 项研究。 13 项研究纳入了年龄限制；一项研究仅包括老年患者，而其他研究则针对年轻人。分别有 11 项、6 项和 3 项研究专门针对临床稳定的患者、患有严重精神病理学的患者和未服用抗精神病药物的患者。 19 项和 18 项研究分别排除了患有身体合并症和药物滥用的患者。因此，当排除一项针对老年患者的研究时，受试者的平均年龄为 23 岁至 42 岁。平均阳性和阴性症状量表总分范围为 54 至 95。24 项研究中未采用比较活性药物组或安慰剂组。 5 项研究进行了症状学盲评估。一般来说，参与临床 PET 研究的受试者相对年轻，症状轻微，并且没有药物滥用或身体合并症。在解释临床 PET 数据时需要考虑这些特征。另一方面，还应该指出的是，这项研究只是定性的，保守的解释是必要的，因为可能存在主观偏见。
While positron emission tomography (PET) studies have provided invaluable data on antipsychotic effects, selection bias remains a serious concern. A systematic review of PET studies that measured dopamine D2receptor blockade with antipsychotics was conducted to examine their inclusion/exclusion criteria, using PubMed, EMBASE, and ClinicalTrials.gov (last search, September 2016). PET studies were included if they measured D2receptor occupancy in patients with schizophrenia and included introduction of antipsychotic treatment or antipsychotic regimen change in a systematic manner. Twenty-six studies were identified. Age limit was included in 13 studies; one study solely included geriatric patients while others targeted younger adults. Eleven, 6, and 3 studies specifically targeted clinically stable patients, patients with severe psychopathology, and antipsychotic-free patients, respectively. Nineteen and 18 studies excluded patients with physical comorbidity and substance abuse, respectively. As a result, the mean age of subjects ranged from 23 to 42 years when one study that targeted geriatric patients was excluded. Mean Positive and Negative Syndrome Scale total scores ranged from 54 to 95. No comparison active-drug or placebo arm was employed in 24 studies. Blind assessment of symptomatology was performed in 5 studies. In general, subjects participating in clinical PET studies were relatively young, presented with mild symptomatology, and were free from substance abuse or physical comorbidities. These characteristics need to be taken into account when clinical PET data are interpreted. On the other hand, it should also be noted that this study was only qualitative and conservative interpretation is necessary for possibility of subjective bias.