The effect of antipsychotics on regional cerebral blood flow and metabolim - clinical and experimetnal study.

1.临床研究为探讨抗精神病药物对脑血流的影响，我们用133氚吸入技术测定了11例精神分裂症患者（9例精神分裂症和2例精神分裂样障碍，平均年龄22.9岁）用药前和用药后约2周的局部脑血流（rCBF）。10名未服药的正常志愿者（平均年龄31.2岁）也进行了为期两周的测量。正常对照组RCBF测量结果具有良好的重复性。平均脑血流量在49.8 ~ 51.4ml/100 g/min之间，服药2周后（氟哌啶醇2.25- 6.0mg/d或舒必利300 mg/d）左额、右颞顶区RCBF较服药前明显下降，但平均脑血流量仅呈下降趋势。在Breif精神病评定量表上，可疑性得分显著下降.实验研究用N-异丙基-P-[125-I]-碘苯丙胺放射自显影定量技术研究了抗精神病药物对大鼠37个脑区rCBF的急性作用。对照组（172.1ml/100 g/min）与氟哌啶醇0.1或1.0mg/kg组（180.8; 164.5）比较无显著性差异。在脑血流的区域分布值上，双侧缰核呈明显增加趋势，而内侧前额叶皮质和外侧核呈减少趋势。长期氟哌啶醇给药的效果尚未完成，但这些临床和实验研究将有助于了解精神抑制剂的抗精神病作用。

1. Clinical studyTo study the effect of antipsychotics on cerebral blood flow, we wxamined regional cerebral blood flow (rCBF) using 133Xe inhalation technique in eleven patients (9 schizophrenics and 2 schizophreniform disorder; mean age, 22.9 years) before and about two weeks after medication. The measurements were also made with a two-week interval for ten normal volunteers without medication (mean age, 31.2 years). RCBF measurements showed good reproducibility in the normal controls. their mean hemispheric blood flow being between 49,8-51.4 ml/100g/min. RCBF in the patients after two-week's medication (haloperidol 2.25-6.0 mg/day or sulpiride 300mg/day) showed a statistically significant decrease in the left frontal and right temporo-parietal region compared with that before treatment, but their mean hemispheric blood flow only showed a tendency to decrease. On the Breif Psychiatric Rating Scale, the score of suspiclousness has significantly dcreased.2. Experimental StudyThe acute effect of antipsychotics on rCBF in 37 discrete regions of the rat brain was studied by the quantitative autoradiographic N-isopropyl-p-[125-I]-Iodoamphetamine technique. There was no significant defference in mean hemispheric blood flow between controls (172.1ml/ 100g/min) and haloperidol 0.1 or 1.0 mg/kg i.v. administated groups (180.8; 164.5). For the regional distribution value of the blood flow, bilateral habenular nucleus showed a significant increase, whereas, medial prefrontal cortex and nucleus accumbens showed a tendency to decrease. The effect of chronic haloperidol administration is not yet completed, but these clinical and experimental studies would contribute to the understanding of the antipsychotic effects of neuroleptics.