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分裂性精神病症状特征与生物标志物:诊断迷宫中的指引

Schizopsychotic symptom-profiles and biomarkers: beacons in diagnostic labyrinths.

作者信息

Palomo Tomas, Kostrzewa Richard M, Beninger Richard J, Archer Trevor

机构信息

Servicio Psiquiatrico, Hospital Universitario 12 de Octubre, 28041 Madrid.

出版信息

Neurotox Res. 2008 Oct;14(2-3):79-96. doi: 10.1007/BF03033800.

Abstract

Several avenues of investigation through which the 'labyrinths' of schizopsychotic diagnosis may be examined, are offered by the consideration of the 'beacons' of symptom-profiles and biomarkers. Neurodevelopmental issues and risk assessment, neurocognitive factors of predictive necessity, supersensitivity in neurotransmitter systems, the implications of prodromal expressions of the disorder, functional dysconnectivity arising from prefrontal to diverse regional patterns and circuits with a neurodevelopmental origin, and heritable gene characteristics are viewed against the backdrop of the schizophrenia spectrum disorders. The associations between adolescent-adult use of cannabis, on the one hand, and, alternatively, the prevalence of chromosomal abnormalities, e.g., GRIK4 and NPAS3, and mental retardation, on the other hand, with the symptom-profiles of schizopsychosis provide further evidence of emerging biomarkers of biological inheritance factors. The involvement of dopamine D1 and D2 receptors, particularly in prefrontal region, with regard to functional integrity of cognitive systems is reviewed. It would appear that considerations of these disorders imply that one essential hub around which much of the neuropathology revolves may be observed in the various expressions of the cognitive and structural insufficiency.

摘要

通过对症状特征和生物标志物这些“灯塔”的考量,提供了几种调查途径,借此可以审视精神分裂症诊断的“迷宫”。神经发育问题与风险评估、预测所需的神经认知因素、神经递质系统的超敏反应、该疾病前驱表现的影响、源自前额叶到具有神经发育起源的不同区域模式和回路的功能失调,以及可遗传的基因特征,都在精神分裂症谱系障碍的背景下进行审视。一方面,青少年至成人使用大麻的情况,另一方面,染色体异常(例如GRIK4和NPAS3)的患病率以及智力迟钝与精神分裂症的症状特征之间的关联,为生物遗传因素新出现的生物标志物提供了进一步证据。本文回顾了多巴胺D1和D2受体,特别是在前额叶区域,对认知系统功能完整性的影响。这些疾病的相关考量似乎表明,在认知和结构功能不足的各种表现中,可能会观察到一个许多神经病理学围绕其展开的关键核心。

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