Weickert Thomas W, Goldberg Terry E, Mishara Aaron, Apud Jose A, Kolachana Bhaskar S, Egan Michael F, Weinberger Daniel R
National Institutes of Health, National Institute of Mental Health, Clinical Brain Disorders Branch, Building 10, Room 4C 101, MSC 1379, Bethesda, MD 20892, USA.
Biol Psychiatry. 2004 Nov 1;56(9):677-82. doi: 10.1016/j.biopsych.2004.08.012.
The gene encoding catechol-O-methyltransferase (COMT), an enzyme that regulates prefrontal cortex dopamine, contains a common functional polymorphism (val(108/158)met) that influences prefrontal cortex function in an allelic dose-dependent manner. A recent study reported that the COMT val(108/158)met polymorphism influences cognitive- and physiologic-related prefrontal cortex responses to antipsychotic treatment. The present study tested the effects of several COMT polymorphisms on the cognitive response to antipsychotic medication in patients with schizophrenia.
Twenty inpatients with schizophrenia or schizoaffective disorder (5 with the val-val genotype, 11 with val-met, and 4 with met-met) were administered cognitive tests at two time points: once after 4 weeks of treatment with antipsychotic medication and once after 4 weeks of placebo administration, according to a counterbalanced, double-blind, within-subject study design.
Patients homozygous for the COMT met allele displayed significant improvement on the working memory task after treatment. Patients homozygous for the COMT val allele did not show working memory improvement with treatment. Other COMT polymorphisms were not associated with significant differences between treatment and placebo conditions.
These results support other data suggesting that the COMT val(108/158)met polymorphism might be an important factor in the cognitive response to antipsychotic medication.
儿茶酚-O-甲基转移酶(COMT)基因所编码的一种酶可调节前额叶皮质多巴胺,该基因存在一种常见的功能性多态性(val(108/158)met),它以等位基因剂量依赖的方式影响前额叶皮质功能。最近一项研究报告称,COMT val(108/158)met多态性影响与认知和生理相关的前额叶皮质对抗精神病药物治疗的反应。本研究测试了几种COMT多态性对精神分裂症患者对抗精神病药物认知反应的影响。
根据一种平衡、双盲、受试者内研究设计,对20名患有精神分裂症或分裂情感性障碍的住院患者(5名携带val-val基因型,11名携带val-met基因型,4名携带met-met基因型)在两个时间点进行认知测试:一次是在使用抗精神病药物治疗4周后,一次是在使用安慰剂4周后。
COMT met等位基因纯合的患者在治疗后工作记忆任务上有显著改善。COMT val等位基因纯合的患者在治疗后工作记忆没有改善。其他COMT多态性与治疗组和安慰剂组之间的显著差异无关。
这些结果支持了其他数据,表明COMT val(108/158)met多态性可能是对抗精神病药物认知反应的一个重要因素。