Comparison of the density of gamma-aminobutyric acid in the ventromedial prefrontal cortex of patients with first-episode psychosis and healthy controls.
Comparison of the density of gamma-aminobutyric acid in the ventromedial prefrontal cortex of patients with first-episode psychosis and healthy controls.
复制标题
首发精神病患者与健康对照者腹内侧前额叶皮质中γ-氨基丁酸密度的比较。
DOI：
10.11919/j.issn.1002-0829.215130
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发表时间：
2015-12-25
期刊：
影响因子：
--
通讯作者：
Liu D
中科院分区：
文献类型：
--
作者：
Yang Z;Zhu Y;Song Z;Mei L;Zhang J;Chen T;Wang Y;Xu Y;Jiang K;Li Y;Liu D
大脑中γ-氨基丁酸（γ-aminobutyric acid，GABA）的浓度和功能异常不仅是精神分裂症病因的重要假设联系，而且还可能与精神分裂症的认知能力下降和阴性症状相关。利用高场磁共振波谱（MRS）的研究报告了慢性精神分裂症患者的腹内侧前额叶皮层（vmPFC）中GABA的异常密度，但这些结果可能会受到研究参与者既往使用抗精神病药物的混淆。 比较首发精神病患者与健康对照者VMPFC中GABA的密度，并评估VMPFC中GABA密度与精神病性症状严重程度的关系。本文应用单体素~ 1H-MRS检测了22例首发精神病患者（10例精神分裂症，12例精神分裂样障碍）和23例健康对照者VMPFC内GABA及其他代谢产物的浓度。22例患者中有13例为药物初治，9例使用抗精神病药物少于3天。采用阳性和阴性症状量表（PANSS）评定患者组精神病性症状的严重程度。患者vmPFC中的平均（sd）GABA密度显著高于对照组（2.28 [0.54] v. 1.93 [0.32] mM，t=2.62，p=0.012）。其他代谢物的密度-包括N-乙酰天冬氨酸（NAA），谷氨酸（GLU）和谷氨酰胺（GLN）-在患者和对照组之间没有显着差异。在这些患者中，vmPFC中的GABA密度与PANSS总分或阳性症状、阴性症状和一般精神病理学的三个PANSS子量表评分均无显著相关性。GABA浓度与病程无关，但与患者年龄显著相关（r=0.47，p=0.026）。首发精神病患者vmPFC中GABA密度升高证实了这种异常与药物使用无关。未能找到一个相关的GABA密度在vmPFC与精神病症状的严重程度需要在更大的研究中得到证实，但它表明，有几个干预步骤之间的大脑病理和临床症状。
Abnormality in the concentration and functioning of gamma-aminobutyric acid (γ-aminobutyric acid, GABA) in the brain is not only an important hypothetical link to the cause of schizophrenia but it may also be correlated with the cognitive decline and negative symptoms of schizophrenia. Studies utilizing high field magnetic resonance spectroscopy (MRS) report abnormal density of GABA in the ventromedial prefrontal cortex (vmPFC) of patients with chronic schizophrenia, but these results may be confounded by study participants’ prior use of antipsychotic medications. Compare the density of GABA in the vmPFC of patients with first-episode psychosis to that in healthy controls and assess the relationship of GABA density in the vmPFC to the severity of psychotic symptoms. Single-voxel 1H-MRS was used to assess the concentration of GABA and other metabolites in the vmPFC of 22 patients with first-episode psychosis (10 with schizophrenia and 12 with schizophreniform disorder) and 23 healthy controls. Thirteen of the 22 patients were drug-naïve and 9 had used antipsychotic medication for less than 3 days. The Positive and Negative Syndrome Scale (PANSS) was used to evaluate the severity of psychotic symptoms in the patient group. The mean (sd) GABA density in the vmPFC was significantly higher in patients than in controls (2.28 [0.54] v. 1.93 [0.32] mM, t=2.62, p=0.012). The densities of other metabolites – including N-acetylaspartic acid (NAA), glutamic acid (GLU), and glutamine (GLN) – were not significantly different between patients and controls. Among the patients, GABA density in the vmPFC was not significantly correlated with PANSS total score or with any of the three PANSS subscale scores for positive symptoms, negative symptoms, and general psychopathology. GABA concentration was not associated with the duration of illness, but it was significantly correlated with patient age (r=0.47, p=0.026). Elevation of GABA density in the vmPFC of patients with first-episode psychosis confirms that this abnormality is independent of medication use. The failure to find a correlation of GABA density in the vmPFC with the severity of psychotic symptoms needs to be confirmed in larger studies, but it suggests that there are several intervening steps between brain pathology and clinical symptoms.