Saito T, Ishizawa H, Tsuchiya F, Ozawa H, Takahata N
Jpn J Psychiatry Neurol. 1986 Jun;40(2):189-94. doi: 10.1111/j.1440-1819.1986.tb03141.x.
Monoamine and their acid metabolites were determined in the CSF of 18 drug-treated chronic schizophrenic patients with the symptoms of tardive dyskinesia and neuroleptic-induced Parkinsonism (Parkinsonism). Six healthy volunteers were used as the control group. The norepinephrine (NE) levels were found to be significantly higher in the patients with tardive dyskinesia than in the controls. Furthermore, elevated CSF NE levels were also observed in the patients with Parkinsonism. Epinephrine (E) and Dopamine (DA) were not present in the CSF of the control group, whereas measurable levels of DA could be detected in 4 out of 9 and E was found in 8 out of 9 patients with tardive dyskinesia. The mean concentration of HVA was slightly but not significantly elevated in the patients with tardive dyskinesia and Parkinsonism. The mean values of CSF 5-HIAA were all within the normal range in both patient groups. From the above results, it was suggested that abnormal adrenergic activity rather than abnormal dopaminergic activity may play an important role as a mechanism in the etiopathogenesis of extra-pyramidal disorders. Furthermore, in the patients with Parkinsonism, CSF neurochemical observations were similar to those of the patients with tardive dyskinesia in this study. It may help to explain the clinical coexistence of tardive dyskinesia and neuroleptic-induced Parkinsonism.
在18例接受药物治疗的慢性精神分裂症患者的脑脊液中测定了单胺及其酸性代谢产物，这些患者伴有迟发性运动障碍和抗精神病药物所致帕金森症（帕金森症）症状。选取6名健康志愿者作为对照组。发现迟发性运动障碍患者脑脊液中的去甲肾上腺素（NE）水平显著高于对照组。此外，帕金森症患者脑脊液中NE水平也升高。对照组脑脊液中未检测到肾上腺素（E）和多巴胺（DA），而在9例迟发性运动障碍患者中，有4例可检测到可测量水平的DA，8例可检测到E。迟发性运动障碍和帕金森症患者中高香草酸（HVA）的平均浓度略有升高，但无统计学意义。两组患者脑脊液5-羟吲哚乙酸（5-HIAA）的平均值均在正常范围内。根据上述结果，提示肾上腺素能活动异常而非多巴胺能活动异常可能在锥体外系疾病的病因发病机制中起重要作用。此外，在本研究中，帕金森症患者的脑脊液神经化学观察结果与迟发性运动障碍患者相似。这可能有助于解释迟发性运动障碍和抗精神病药物所致帕金森症的临床共存现象。
