Blennow K, Bogdanovic N, Heilig M, Grenfeldt B, Karlsson I, Davidsson P
Göteborg University, Institute of Clinical Neuroscience, Department of Psychiatry and Neurochemistry, Sahlgren's University Hospital, Mölndal, Sweden.
J Neural Transm (Vienna). 2000;107(8-9):1085-97. doi: 10.1007/s007020070054.
Although the psychotic symptoms in schizophrenia can be alleviated by treatment with dopaminergic receptor antagonists, the etiology and underlying neurochemical pathology remains obscure. Both neuropathological and magnetic resonance imaging studies have found evidence for neuronal loss and atrophy in the thalamus in schizophrenia, implicating this key structure for gating information to cortical areas in the pathophysiology. Recent studies have also found evidence of synaptic loss in the thalamus in schizophrenia. To further examine possible synaptic disturbances, we studied the synaptic related protein rab3a as a marker for synaptic density, using both quantitative Western blotting and immunohistochemistry. The material consisted of brains from 22 schizophrenic patients (mean age 79.3 years), and 24 control subjects (74.8 years). Reduced rab3a protein levels were found in the left thalamus in schizophrenia (0.47 +/- 0.17 vs. 1.00 +/- 0.18; p < 0.0001), while a less marked decrease was found also in the right thalamus (0.75 +/- 0.13 vs. 1.00 +/- 0.09; p < 0.0001). Immunohistochemistry, performed on two schizophrenic and two control brains, revealed that rab3a immunoreactivity was most reduced in the left anterior and mediodorsal thalamic nuclei. Therefore, we extended the study to brain regions connected these thalamic nuclei. Reduced rab3a protein levels were found schizophrenia also in the frontal cortex, hippocampus, gyrus cinguli, and parietal cortex, while no significant differences were found in the temporal cortex, or in cerebellum. The reduction in rab3a was not found to be secondary to confounding factors such as age-differences, post-mortem delay time, generalized brain atrophy, or antipsychotic medication. Therefore, the reduction of rab3a probably reflects synaptic disturbances, possibly synaptic loss, in the limbic system and neocortical areas, in schizophrenia. This part of the brain is known to be involved in behavioral and emotional control, and thus to be crucial for higher mental functions, suggesting that synaptic disturbances in the limbic system may be of importance in the development of psychotic symptoms in schizophrenia.
虽然精神分裂症的精神病性症状可用多巴胺能受体拮抗剂治疗缓解,但其病因及潜在的神经化学病理仍不清楚。神经病理学和磁共振成像研究均已发现精神分裂症患者丘脑存在神经元丢失和萎缩的证据,这表明该关键结构在病理生理学中对信息传入皮质区域起到了门控作用。最近的研究还发现精神分裂症患者丘脑存在突触丢失的证据。为进一步研究可能的突触紊乱,我们使用定量蛋白质免疫印迹法和免疫组织化学方法,对与突触密度相关的蛋白rab3a进行了研究。研究材料包括22例精神分裂症患者(平均年龄79.3岁)和24例对照者(74.8岁)的大脑。结果发现,精神分裂症患者左侧丘脑的rab3a蛋白水平降低(0.47±0.17对1.00±0.18;p<(0.0001)),右侧丘脑也有较明显降低(0.75±0.13对1.00±0.09;p<(0.0001))。对2例精神分裂症患者和2例对照者的大脑进行免疫组织化学分析发现,rab3a免疫反应性在左侧丘脑前核和背内侧核中降低最为明显。因此,我们将研究扩展至与这些丘脑核相连的脑区。结果发现,精神分裂症患者的额叶皮质、海马、扣带回和顶叶皮质中rab3a蛋白水平也降低,而颞叶皮质和小脑中未发现显著差异。未发现rab3a水平降低是由年龄差异、死后延迟时间、全脑萎缩或抗精神病药物治疗等混杂因素所致。因此,rab3a水平降低可能反映了精神分裂症患者边缘系统和新皮质区域的突触紊乱,可能是突触丢失。已知该脑区参与行为和情绪控制,因此对高级心理功能至关重要,这表明边缘系统的突触紊乱可能在精神分裂症精神病性症状的发生中具有重要作用。