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[遗传和药理学对精神分裂症前额叶皮质功能的影响]

[Genetic and pharmacological effects on prefrontal cortical function in schizophrenia].

作者信息

Heinz Andreas, Braus Dieter F, Romero Berenice, Gallinat Jürgen, Puls Imke, Juckel Georg, Weinberger Daniel R

机构信息

Klinik für Psychiatrie und Psychotherapie, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin.

出版信息

Nervenarzt. 2004 Sep;75(9):845-56. doi: 10.1007/s00115-004-1713-8.

Abstract

Brain imaging studies with PET, SPECT, functional magnetic resonance imaging, and spectroscopy provide evidence of prefrontal dysfunction in schizophrenia. Dysfunction of the prefrontal cortex is associated with cognitive impairment and negative symptoms. Combined multimodal imaging shows that a developmentally early disturbance of frontotemporal-limbic neuronal networks is associated with a disinhibition of subcortical dopaminergic neurotransmission. Current studies imply genetic factors in the regulation of dopaminergic neurotransmission and their effects on prefrontal cortex function. Some studies also indicate that atypical neuroleptics may at least partially improve frontal cortex function. We review the literature and discuss genotype and medication effects on frontal dysfunction in schizophrenia. Molecular brain imaging combines imaging techniques with the assessment of genotype effects and represents a powerful tool for the understanding of neuropsychiatric disorders.

摘要

正电子发射断层扫描(PET)、单光子发射计算机断层扫描(SPECT)、功能磁共振成像及光谱学等脑成像研究为精神分裂症患者前额叶功能障碍提供了证据。前额叶皮质功能障碍与认知损害及阴性症状相关。联合多模态成像显示,额颞叶-边缘神经网络在发育早期出现的紊乱与皮质下多巴胺能神经传递的去抑制有关。目前的研究提示了多巴胺能神经传递调节中的遗传因素及其对前额叶皮质功能的影响。一些研究还表明,非典型抗精神病药物可能至少部分改善额叶皮质功能。我们回顾了相关文献,并讨论了精神分裂症患者前额叶功能障碍的基因型及药物治疗影响。分子脑成像将成像技术与基因型效应评估相结合,是理解神经精神疾病的有力工具。

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