精神分裂症和双相情感障碍自杀生物标志物候选物的探索性研究。
Exploratory investigation of biomarker candidates for suicide in schizophrenia and bipolar disorder.
作者信息
Youssef Nagy A, Bradford Daniel W, Kilts Jason D, Szabo Steven T, Naylor Jennifer C, Allen Trina B, Strauss Jennifer L, Hamer Robert M, Brancu Mira, Shampine Lawrence J, Marx Christine E
机构信息
<location>Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA</location> <location>Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA</location>
<location>Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA</location> <location>Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA</location> <location>Center for Health Services Research in Primary Care, Durham, NC, USA</location>
出版信息
Crisis. 2015;36(1):46-54. doi: 10.1027/0227-5910/a000280.
BACKGROUND
Clozapine and lithium increase neurosteroids in rodents, and both drugs demonstrate antisuicidal actions. We therefore hypothesized that neurosteroid levels may be reduced in patients with schizophrenia or bipolar disorder who completed suicide.
AIMS
To investigate neurosteroid levels in the parietal cortex and posterior cingulate in schizophrenia and bipolar patients who died by suicide, and compare them with patients with these disorders who died of other causes.
METHOD
Neurosteroid levels were quantified by gas chromatography/mass spectrometry in the parietal cortex and posterior cingulate. Mann-Whitney analyses were conducted in exploratory post hoc analyses to investigate neurosteroids as possible biomarker candidates for suicide.
RESULTS
The study showed that pregnenolone was significantly decreased in the parietal cortex in the combined group of patients with schizophrenia or bipolar disorder who died by suicide (n = 13) compared with patients with these disorders who died of other causes (n = 17, p = .02). Pregnenolone levels were also lower in the parietal cortex in the individual group of schizophrenia patients who died by suicide (n = 4) compared with schizophrenia patients who died of other causes (n = 11) p = .04).
CONCLUSION
Pregnenolone alterations may be relevant to the neurobiology of suicide in schizophrenia and bipolar disorder.
背景
氯氮平和锂可增加啮齿动物体内的神经甾体，且这两种药物均具有抗自杀作用。因此，我们推测，完成自杀的精神分裂症或双相情感障碍患者的神经甾体水平可能会降低。
目的
研究自杀死亡的精神分裂症和双相情感障碍患者顶叶皮质和后扣带回中的神经甾体水平，并将其与因其他原因死亡的这些疾病患者进行比较。
方法
采用气相色谱/质谱法对顶叶皮质和后扣带回中的神经甾体水平进行定量分析。在探索性事后分析中进行曼-惠特尼分析，以研究神经甾体作为自杀潜在生物标志物的可能性。
结果
研究表明，与因其他原因死亡的精神分裂症或双相情感障碍患者（n = 17，p = 0.02）相比，自杀死亡的此类患者联合组（n = 13）的顶叶皮质中孕烯醇酮水平显著降低。与因其他原因死亡的精神分裂症患者（n = 11，p = 0.04）相比，自杀死亡的精神分裂症患者个体组（n = 4）的顶叶皮质中孕烯醇酮水平也较低。
结论
孕烯醇酮的改变可能与精神分裂症和双相情感障碍自杀的神经生物学机制有关。
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