Perry William, Feifel David, Minassian Arpi, Bhattacharjie Indira, Braff David L
Neuropsychiatry and Behavioral Medicine Service, Department of Psychiatry, University of California San Diego, La Jolla 92093-8620, USA.
Am J Psychiatry. 2002 Aug;159(8):1375-81. doi: 10.1176/appi.ajp.159.8.1375.
In patients with schizophrenia, information processing deficits, such as those reported in studies that measured prepulse inhibition of the human startle response and habituation of startle magnitude, may be improved with atypical antipsychotic treatment. However, it remains unclear whether antipsychotic medication is directly responsible for the improvement or whether differences in prepulse inhibition reflect other factors, such as acuity status. The present study investigated the effects of antipsychotics on prepulse inhibition and startle habituation in acutely hospitalized patients with schizophrenia.
Forty-one acutely psychotic schizophrenia patients (21 who were unmedicated at the time of admission and 20 who had been receiving antipsychotic treatment) were tested within 72 hours of hospital admission. Thirteen healthy subjects were also studied for comparative purposes. Primary dependent measures were startle responsivity, reactivity, prepulse inhibition, and startle habituation.
Schizophrenia patients, whether medicated or unmedicated at admission, showed prepulse inhibition deficits compared with healthy subjects and did not statistically differ from each other in startle magnitude, prepulse inhibition, or habituation. There was a higher number of startle "nonresponders" among those who had been receiving medication versus those unmedicated at the time of admission.
The present findings suggest that antipsychotic effects on prepulse inhibition may not be evident at a time when schizophrenia patients are acutely symptomatic. These results suggest that the neurobiological substrate underlying prepulse inhibition deficits may be dysregulated during acute psychotic states while the patients are in early phases of medication treatment.
在精神分裂症患者中,信息处理缺陷,如在测量人类惊吓反应的前脉冲抑制和惊吓幅度习惯化的研究中所报告的那些缺陷,可能会通过非典型抗精神病药物治疗得到改善。然而,尚不清楚抗精神病药物是否直接导致了这种改善,或者前脉冲抑制的差异是否反映了其他因素,如敏锐度状态。本研究调查了抗精神病药物对急性住院精神分裂症患者前脉冲抑制和惊吓习惯化的影响。
41名急性精神病性精神分裂症患者(21名入院时未用药,20名一直在接受抗精神病药物治疗)在入院72小时内接受测试。还研究了13名健康受试者以作比较。主要的因变量是惊吓反应性、反应性、前脉冲抑制和惊吓习惯化。
与健康受试者相比,精神分裂症患者,无论入院时是否用药,均表现出前脉冲抑制缺陷,并且在惊吓幅度、前脉冲抑制或习惯化方面彼此之间无统计学差异。在入院时接受药物治疗的患者中,惊吓“无反应者”的数量高于未用药者。
目前的研究结果表明,在精神分裂症患者急性症状发作时,抗精神病药物对前脉冲抑制的作用可能不明显。这些结果表明,在前脉冲抑制缺陷背后的神经生物学底物可能在急性精神病状态下、患者处于药物治疗早期时失调。