谷胱甘肽前体N-乙酰半胱氨酸可改善精神分裂症患者的失配负波。
Glutathione precursor, N-acetyl-cysteine, improves mismatch negativity in schizophrenia patients.
作者信息
Lavoie Suzie, Murray Micah M, Deppen Patricia, Knyazeva Maria G, Berk Michael, Boulat Olivier, Bovet Pierre, Bush Ashley I, Conus Philippe, Copolov David, Fornari Eleonora, Meuli Reto, Solida Alessandra, Vianin Pascal, Cuénod Michel, Buclin Thierry, Do Kim Q
机构信息
Center for Psychiatric Neuroscience, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
出版信息
Neuropsychopharmacology. 2008 Aug;33(9):2187-99. doi: 10.1038/sj.npp.1301624. Epub 2007 Nov 14.
In schizophrenia patients, glutathione dysregulation at the gene, protein and functional levels, leads to N-methyl-D-aspartate (NMDA) receptor hypofunction. These patients also exhibit deficits in auditory sensory processing that manifests as impaired mismatch negativity (MMN), which is an auditory evoked potential (AEP) component related to NMDA receptor function. N-acetyl-cysteine (NAC), a glutathione precursor, was administered to patients to determine whether increased levels of brain glutathione would improve MMN and by extension NMDA function. A randomized, double-blind, cross-over protocol was conducted, entailing the administration of NAC (2 g/day) for 60 days and then placebo for another 60 days (or vice versa). 128-channel AEPs were recorded during a frequency oddball discrimination task at protocol onset, at the point of cross-over, and at the end of the study. At the onset of the protocol, the MMN of patients was significantly impaired compared to sex- and age- matched healthy controls (p=0.003), without any evidence of concomitant P300 component deficits. Treatment with NAC significantly improved MMN generation compared with placebo (p=0.025) without any measurable effects on the P300 component. MMN improvement was observed in the absence of robust changes in assessments of clinical severity, though the latter was observed in a larger and more prolonged clinical study. This pattern suggests that MMN enhancement may precede changes to indices of clinical severity, highlighting the possible utility AEPs as a biomarker of treatment efficacy. The improvement of this functional marker may indicate an important pathway towards new therapeutic strategies that target glutathione dysregulation in schizophrenia.
在精神分裂症患者中,基因、蛋白质和功能水平上的谷胱甘肽失调会导致N-甲基-D-天冬氨酸(NMDA)受体功能减退。这些患者在听觉感觉处理方面也存在缺陷,表现为失匹配负波(MMN)受损,MMN是一种与NMDA受体功能相关的听觉诱发电位(AEP)成分。向患者施用谷胱甘肽前体N-乙酰半胱氨酸(NAC),以确定脑内谷胱甘肽水平的升高是否会改善MMN,进而改善NMDA功能。进行了一项随机、双盲、交叉试验,即给予NAC(2克/天)60天,然后给予安慰剂60天(或反之)。在试验开始时、交叉点和研究结束时,在频率oddball辨别任务期间记录128通道AEP。在试验开始时,与性别和年龄匹配的健康对照相比,患者的MMN明显受损(p = 0.003),没有任何伴随P300成分缺陷的证据。与安慰剂相比,NAC治疗显著改善了MMN的产生(p = 0.025),对P300成分没有任何可测量的影响。在临床严重程度评估没有明显变化的情况下观察到MMN有所改善,不过在一项更大、更长期的临床研究中观察到了后者。这种模式表明,MMN增强可能先于临床严重程度指标的变化,突出了AEP作为治疗疗效生物标志物的可能效用。这种功能标志物的改善可能表明了一条通向针对精神分裂症中谷胱甘肽失调的新治疗策略的重要途径。