Study on Action Mechanisms of Antipsychotics with SPECT in Schizophrenic Patients.

为探讨氟哌啶醇（HPD）的抗精神病作用，用~（99）mTc-HMPAO单光子发射计算机断层扫描（SPECT）观察了12例初治精神分裂症患者长期口服HPD 4.5mg/d后局部脑血流量（rCBF）的变化。并对20名正常成人志愿者进行SPECT检查，探讨精神分裂症患者与正常人rCBF的差异，结果如下：1.与正常对照组相比，精神分裂症患者双侧额上级和额中、扣带回、颞中、中央前回和中央后回、左侧上级颞回、双侧顶下小叶、双侧海马和丘脑皮质的rCBF值显著增加。然而，与正常对照组相比，HPD剂量后的rCBF值仅在双侧中央前回和中央后回显著增加。 ...更多信息 目标2.与HPD给药前相比，HPD给药后双侧上级、额中、额下、颞上级、颞中回、左侧岛回的rCBF值明显降低. PANSS精神评估显示HPD给药后阳性症状（包括幻听和妄想）改善。对HPD给药前后rCBF值与PANSS评分的相关性进行统计学分析，结果显示，右侧额下回与幻听或阳性症状呈正相关，右侧上级颞回、左侧丘脑与妄想呈正相关，左侧丘脑、这些结果表明，急性药物初治精神分裂症患者有广泛的皮质，因此，HPD降低了皮质下能量高代谢，导致整个正常化的脑代谢，特别是额叶和颞叶中较大的区域选择性减少，这减少了幻觉和妄想。少

For the purpose of examining antipsychotic action of haloperidol (HPD), effects of chronic perioral administration of HPD 4.5 mg/day on regional cerebral blood flow (rCBF) with 99mTc-HMPAO SPECT were investigated in 12 drug-naive schizophrenic patients with acute hallucinatory and delusional state. Further, the SPECT examinations were perfomed on 20 normal adult volunteers to investigate differences in rCBFs between schizophrenics and the normal subjects.Results are itemized as follows.1. The rCBF values were significantly increased in the bilateral superior and middle frontal, cingulate, middle temporal, pre-and post-central gyri, the left superior temporal gyrus, the bilateral inferior parietal lobule, and the bilateral hippocampal and thalamic cortices in comparison between normal subjects and before the HPD dose in schizophrenics. However, the rCBF values after the HPD dose showed significant increases only in the bilateral pre-and post-central gyri in comparison with the normal su … More bjects.2. The rCBF values were significantly decreased in the bilateral superior, middle and inferior frontal, superior and middle temporal gyri, and the left insular gyrus after the HPD dose in comparison with before the HPD dose.3. The psychiatric assessment with PANSS showed an improvement of positive symptoms consisting of auditory hallucination and delusions after the HPD dose. Statistical analyses on relationships between the rCBF values and PANSS scores before and after the HPD dose showed positive correlations between the right inferior frontal gyrus and auditory hallucination or positive symptoms, between the right superior temporal gyrus, left thalamus and delusions, and between the left thalamus, insular gyrus and negative symptoms.These results suggest that acute drug-naive schizophrenia patients have widespread cortico-subcorticall energic hypermetabolism and HPD reduces the hypermetabolism, leading to whole normalized brain metabolism, in particular with the larger region-selective reduction in the frontal and temporal lobes, which decreases hallucination and delusion. Less