Newton Samuel S, Duman Ronald S
Division of Molecular Psychiatry, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06508, USA.
CNS Drugs. 2007;21(9):715-25. doi: 10.2165/00023210-200721090-00002.
Brain imaging and postmortem studies have reported a reduction in the volume of discrete brain regions, as well as cellular abnormalities in schizophrenic patients. In addition, basic research studies have demonstrated effects of antipsychotic drugs on cell morphology and number. Of particular interest is adult neurogenesis, which has been linked to cognitive and memory improvements, and is also associated with the behavioural actions of antidepressants. While the action of antidepressant treatment is restricted mainly to the hippocampus, long-term administration of antipsychotics is reported to increase neurogenesis in the subventricular zone (SVZ), as well as the subgranular zone (SGZ) of the hippocampus. In addition, antipsychotic drugs increase the proliferation of non-neuronal cell types in the prefrontal cortex and could thereby influence the function of this brain region. Typical and atypical antipsychotic drugs differentially regulate neurogenesis in the SVZ and SGZ. Although the therapeutic relevance remains speculative, the results are consistent with the hypothesis that the actions of antipsychotic agents could be mediated, in part, by increased proliferation of neuronal as well as glial cells. Additional animal studies and postmortem analyses are required to further test this possibility and to investigate the relevance of this work in the pathophysiology and treatment of schizophrenia.
脑成像和尸检研究报告称，精神分裂症患者的离散脑区体积减小，同时存在细胞异常。此外，基础研究表明抗精神病药物对细胞形态和数量有影响。特别值得关注的是成年神经发生，它与认知和记忆改善有关，也与抗抑郁药的行为作用相关。虽然抗抑郁治疗的作用主要局限于海马体，但据报道，长期服用抗精神病药物会增加脑室下区（SVZ）以及海马体颗粒下区（SGZ）的神经发生。此外，抗精神病药物会增加前额叶皮质中非神经元细胞类型的增殖，从而可能影响该脑区的功能。典型和非典型抗精神病药物对SVZ和SGZ中的神经发生有不同的调节作用。尽管其治疗相关性仍属推测，但这些结果与以下假设一致，即抗精神病药物的作用可能部分是由神经元和神经胶质细胞增殖增加介导的。需要更多的动物研究和尸检分析来进一步验证这种可能性，并研究这项工作在精神分裂症病理生理学和治疗中的相关性。
