Heritch A J
Dept. of Psychiatry, Medical College of Wisconsin, Milwaukee 53226.
Schizophr Bull. 1990;16(4):605-15. doi: 10.1093/schbul/16.4.605.
The dopamine (DA) hypothesis of schizophrenia proposes that schizophrenia is related to dopaminergic hyperactivity. To examine this hypothesis, this article reviews studies that have measured levels of DA and its metabolites in schizophrenic patients. From these studies, the following conclusions about schizophrenia emerge: (1) levels of DA and its metabolites can be highly variable; (2) DA turnover appears to be reduced in a subgroup of schizophrenic patients characterized as more chronic and treatment refractory, compared with normal controls; (3) DA turnover has been correlated positively with acute symptomatology and negatively with signs of chronic illness; and (4) central DA levels appear to be elevated. These conclusions support the author's hypothesis that DA turnover may be both reduced and dysregulated in schizophrenia. It is speculated that reduced turnover is primarily due to a deficiency in DA release and that dysregulation may result from the disruption of feedback mechanisms. Acute psychosis may be associated with a relative increase in the release of DA impinging on supersensitive postsynaptic receptors made so by chronic synaptic depletion of the transmitter.
精神分裂症的多巴胺（DA）假说提出，精神分裂症与多巴胺能亢进有关。为检验这一假说，本文回顾了测量精神分裂症患者体内DA及其代谢物水平的研究。从这些研究中，得出了以下关于精神分裂症的结论：（1）DA及其代谢物的水平可能高度可变；（2）与正常对照组相比，在一组以病程较长且治疗难治为特征的精神分裂症患者中，DA周转率似乎降低；（3）DA周转率与急性症状呈正相关，与慢性病体征呈负相关；（4）中枢DA水平似乎升高。这些结论支持了作者的假说，即精神分裂症中DA周转率可能既降低又失调。据推测，周转率降低主要是由于DA释放不足，而失调可能是由反馈机制破坏所致。急性精神病可能与作用于超敏突触后受体的DA释放相对增加有关，这种超敏是由递质的慢性突触耗竭造成的。
