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[精神分裂症患者的递质功能障碍。对认知功能及治疗的意义]

[Transmitter dysfunction in patients with schizophrenia. Significance for cognitive functioning and treatment].

作者信息

Glenthøj B Y, Mackeprang T, Bille A E, Hemmingsen R P

出版信息

Ugeskr Laeger. 1999 Mar 8;161(10):1391-8.

Abstract

The great diversity of schizophrenic symptoms rules out one simple etiological explanation. However,impairment of information processing, including disruption of sensorimotor gating, is a consistent finding in schizophrenic patients. Dysfunction in sensorimotor gating is believed to be the result of different developmentally or environmentally caused disturbances involving the neural trajectories involved in information processing. Psychopathology and cognition will depend on the primary involvement of distinct parts of these circuits and on secondarily derived time-dependent disturbances of transmitter function. This review is focused on clinical and preclinical evidence for the impact of interactions between glutamatergic, dopaminergic, serotonergic and noradrenergic brain systems on cognitive performance. The hypothetical consequences of transmitter dysfunction for progressive development of impairment in sensorimotor gating are illustrated. Finally, the broad receptor profile of second generation antipsychotics is analysed to explain the clinical improvement in neurocognition that may occur during treatment with such drugs.

摘要

精神分裂症症状的巨大多样性排除了单一病因解释的可能性。然而,信息处理受损,包括感觉运动门控的破坏,在精神分裂症患者中是一个一致的发现。感觉运动门控功能障碍被认为是由不同的发育或环境因素引起的干扰所致,这些干扰涉及信息处理中所涉及的神经轨迹。精神病理学和认知将取决于这些回路不同部分的主要受累情况以及继发的与时间相关的递质功能紊乱。本综述聚焦于谷氨酸能、多巴胺能、5-羟色胺能和去甲肾上腺素能脑系统之间相互作用对认知表现影响的临床和临床前证据。阐述了递质功能障碍对感觉运动门控损害进行性发展的假设后果。最后,分析了第二代抗精神病药物广泛的受体谱,以解释使用此类药物治疗期间可能出现的神经认知方面的临床改善。

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