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精神分裂症患者黑质存在神经病理学改变,而抑郁症患者则无。

Neuropathological changes in the substantia nigra in schizophrenia but not depression.

作者信息

Williams M R, Galvin K, O'Sullivan B, MacDonald C D, Ching E W K, Turkheimer F, Howes O D, Pearce R K B, Hirsch S R, Maier M

机构信息

Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK,

出版信息

Eur Arch Psychiatry Clin Neurosci. 2014 Jun;264(4):285-96. doi: 10.1007/s00406-013-0479-z. Epub 2013 Dec 29.

Abstract

Schizophrenia is a chronic, disabling neuropsychiatric disorder characterised by positive, negative and cognitive symptoms. The aetiology is not known, although genetic, imaging and pathological studies have implicated both neurodevelopmental and neurodegenerative processes. The substantia nigra is a basal ganglia nucleus responsible for the production of dopamine and projection of dopaminergic neurons to the striatum. The substantia nigra is implicated in schizophrenia as dopamine has been heavily implicated in the dopamine hypothesis of schizophrenia and the prevalent psychotic symptoms and the monoamine theory of depression, and is a target for the development of new therapies. Studies into the major dopamine delivery pathways in the brain will therefore provide a strong base in improving knowledge of these psychiatric disorders. This post-mortem study examines the cytoarchitecture of dopaminergic neurons of the substantia nigra in schizophrenia (n = 12) and depression (n = 13) compared to matched controls (n = 13). Measures of nucleolar volume, nuclear length and nuclear area were taken in patients with chronic schizophrenia and major depressive disorder against matched controls. Astrocyte density was decreased in schizophrenia compared to controls (p = 0.030), with no change in oligodendrocyte density observed. Significantly increased nuclear cross-sectional area (p = 0.017) and length (p = 0.021), and increased nucleolar volume (p = 0.037) in dopaminergic neurons were observed in schizophrenia patients compared with controls, suggesting nuclear pleomorphic changes. No changes were observed in depression cases compared to control group. These changes may reflect pathological alterations in gene expression, neuronal structure and function in schizophrenia.

摘要

精神分裂症是一种慢性、致残性神经精神障碍,其特征为阳性、阴性和认知症状。尽管遗传、影像学和病理学研究表明神经发育和神经退行性变过程均与之相关,但其病因尚不清楚。黑质是基底神经节核,负责多巴胺的产生以及多巴胺能神经元向纹状体的投射。黑质与精神分裂症有关,因为多巴胺在精神分裂症的多巴胺假说、常见的精神病性症状以及抑郁症的单胺理论中都起着重要作用,并且是新疗法开发的靶点。因此,对大脑中主要多巴胺传递途径的研究将为增进对这些精神障碍的了解提供坚实基础。这项尸检研究比较了精神分裂症患者(n = 12)和抑郁症患者(n = 13)与匹配对照组(n = 13)黑质中多巴胺能神经元的细胞结构。对慢性精神分裂症患者和重度抑郁症患者以及匹配对照组进行了核仁体积、核长度和核面积的测量。与对照组相比,精神分裂症患者的星形胶质细胞密度降低(p = 0.030),少突胶质细胞密度未见变化。与对照组相比,精神分裂症患者的多巴胺能神经元核横截面积(p = 0.017)和长度(p = 0.021)显著增加,核仁体积增大(p = 0.037),提示核多形性改变。与对照组相比,抑郁症患者未见变化。这些变化可能反映了精神分裂症患者基因表达、神经元结构和功能的病理改变。

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