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精神分裂症的“双头”潜伏抑制模型:对阳性和阴性症状及其治疗进行建模

The "two-headed" latent inhibition model of schizophrenia: modeling positive and negative symptoms and their treatment.

作者信息

Weiner Ina

机构信息

Department of Psychology, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

Psychopharmacology (Berl). 2003 Sep;169(3-4):257-97. doi: 10.1007/s00213-002-1313-x. Epub 2003 Feb 25.

Abstract

RATIONALE

Latent inhibition (LI), namely, poorer performance on a learning task involving a previously pre-exposed non-reinforced stimulus, is disrupted in the rat by the dopamine (DA) releaser amphetamine which produces and exacerbates psychotic (positive) symptoms, and this is reversed by treatment with typical and atypical antipsychotic drugs (APDs) which on their own potentiate LI. These phenomena are paralleled by disrupted LI in normal amphetamine-treated humans, in high schizotypal humans, and in schizophrenia patients in the acute stages of the disorder, as well as by potentiated LI in normal humans treated with APDs. Consequently, disrupted LI is considered to provide an animal model of positive symptoms of schizophrenia with face, construct and predictive validity.

OBJECTIVES

To review most of the rodent data on the neural substrates of LI as well as on the effects of APDs on this phenomenon with an attempt to interpret and integrate these data within the framework of the switching model of LI; to show that there are two distinct LI models, disrupted and abnormally persistent LI; to relate these findings to the clinical condition.

RESULTS

The nucleus accumbens (NAC) and its DA innervation form a crucial component of the neural circuitry of LI, and are involved at the conditioning stage. There is a clear functional differentiation between the NAC shell and core subregions whereby damage to the shell disrupts LI and damage to the core renders LI abnormally persistent under conditions that disrupt LI in normal rats. The effects of shell and core lesions parallel those produced by lesions to the major sources of input to the NAC: entorhinal cortex lesion, like shell lesion, disrupts LI, whereas hippocampal lesion, like core lesion, produces persistent LI with changes in context, and basolateral amygdala (BLA) lesion, like core lesion, produces persistent LI with extended conditioning. Systemically induced blockade of glutamatergic as well as DA transmission produce persistent LI via effects exerted at the conditioning stage, whereas enhancement of DA transmission disrupts LI via effects at the conditioning stage. Serotonergic manipulations can disrupt or potentiate LI via effects at the pre-exposure stage. Both typical and atypical APDs potentiate LI via effects at conditioning whereas atypical APDs in addition disrupt LI via effects at pre-exposure. Schizophrenia patients can exhibit disrupted or normal LI as a function of the state of the disorder (acute versus chronic), as well as persistent LI.

CONCLUSIONS

Different drug and lesion manipulations produce two poles of abnormality in LI, namely, disrupted LI under conditions which lead to LI in normal rats, and abnormally persistent LI under conditions which disrupt it in normal rats. Disrupted and persistent LI are differentially responsive to APDs, with the former reversed by both typical and atypical APDs and the latter selectively reversed by atypical APDs. It is suggested that this "two-headed LI model" mimics two extremes of deficient cognitive switching seen in schizophrenia, excessive and retarded switching between associations, mediated by dysfunction of different brain circuitries, and can serve to model positive symptoms of schizophrenia and typical antipsychotic action, as well as negative symptoms of schizophrenia and atypical antipsychotic action.

摘要

理论依据

潜伏抑制(LI),即在涉及先前预暴露的非强化刺激的学习任务中表现较差,在大鼠中会被多巴胺(DA)释放剂苯丙胺破坏,苯丙胺会产生并加剧精神病性(阳性)症状,而使用典型和非典型抗精神病药物(APD)治疗可逆转这种情况,这些药物本身会增强潜伏抑制。在正常服用苯丙胺的人类、高精神分裂症型人格的人类以及处于疾病急性期的精神分裂症患者中,也会出现潜伏抑制破坏的情况,而在服用抗精神病药物的正常人类中则会出现潜伏抑制增强的情况。因此,潜伏抑制破坏被认为是一种具有表面效度、结构效度和预测效度的精神分裂症阳性症状动物模型。

目的

回顾关于潜伏抑制神经基质以及抗精神病药物对该现象影响的大多数啮齿动物数据,试图在潜伏抑制转换模型的框架内解释和整合这些数据;表明存在两种不同的潜伏抑制模型,即破坏型和异常持续型潜伏抑制;将这些发现与临床情况联系起来。

结果

伏隔核(NAC)及其多巴胺神经支配是潜伏抑制神经回路的关键组成部分,并参与条件作用阶段。NAC壳和核心亚区域之间存在明显的功能差异,即壳损伤会破坏潜伏抑制,而在正常大鼠中破坏潜伏抑制的条件下,核心损伤会使潜伏抑制异常持续。壳和核心损伤的影响与NAC主要输入源损伤所产生的影响相似:内嗅皮层损伤与壳损伤一样,会破坏潜伏抑制,而海马损伤与核心损伤一样,会在情境变化时产生持续的潜伏抑制,基底外侧杏仁核(BLA)损伤与核心损伤一样,会在延长条件作用时产生持续的潜伏抑制。全身诱导的谷氨酸能以及多巴胺传递阻断通过在条件作用阶段产生的影响导致持续的潜伏抑制,而多巴胺传递增强则通过在条件作用阶段的影响破坏潜伏抑制。5-羟色胺能操作可通过在预暴露阶段产生的影响破坏或增强潜伏抑制。典型和非典型抗精神病药物均通过在条件作用阶段产生的影响增强潜伏抑制,而非典型抗精神病药物还通过在预暴露阶段产生的影响破坏潜伏抑制。精神分裂症患者根据疾病状态(急性与慢性)可表现出潜伏抑制破坏或正常,以及持续的潜伏抑制。

结论

不同的药物和损伤操作在潜伏抑制中产生两种异常极点,即在正常大鼠中导致潜伏抑制的条件下出现破坏型潜伏抑制,以及在正常大鼠中破坏潜伏抑制的条件下出现异常持续型潜伏抑制。破坏型和持续型潜伏抑制对抗精神病药物的反应不同,前者可被典型和非典型抗精神病药物逆转,后者则被非典型抗精神病药物选择性逆转。有人提出,这种“双头潜伏抑制模型”模拟了精神分裂症中出现的认知转换缺陷的两个极端,即联想之间过度和延迟的转换,由不同脑回路功能障碍介导,可用于模拟精神分裂症的阳性症状和典型抗精神病作用,以及精神分裂症的阴性症状和非典型抗精神病作用。

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