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开发精神分裂症认知缺陷的治疗方法:转化的挑战。

Developing treatments for cognitive deficits in schizophrenia: the challenge of translation.

作者信息

Young J W, Geyer M A

机构信息

Department of Psychiatry, University of California San Diego, La Jolla, CA, USA

Research Service, VA San Diego Healthcare System, San Diego, CA, USA.

出版信息

J Psychopharmacol. 2015 Feb;29(2):178-96. doi: 10.1177/0269881114555252. Epub 2014 Dec 16.

Abstract

Schizophrenia is a life-long debilitating mental disorder affecting tens of millions of people worldwide. The serendipitous discovery of antipsychotics focused pharmaceutical research on developing a better antipsychotic. Our understanding of the disorder has advanced however, with the knowledge that cognitive enhancers are required for patients in order to improve their everyday lives. While antipsychotics treat psychosis, they do not enhance cognition and hence are not antischizophrenics. Developing pro-cognitive therapeutics has been extremely difficult, however, especially when no approved treatment exists. In lieu of stumbling on an efficacious treatment, developing targeted compounds can be facilitated by understanding the neural mechanisms underlying altered cognitive functioning in patients. Equally importantly, these cognitive domains will need to be measured similarly in animals and humans so that novel targets can be tested prior to conducting expensive clinical trials. To date, the limited similarity of testing across species has resulted in a translational bottleneck. In this review, we emphasize that schizophrenia is a disorder characterized by abnormal cognitive behavior. Quantifying these abnormalities using tasks having cross-species validity would enable the quantification of comparable processes in rodents. This approach would increase the likelihood that the neural substrates underlying relevant behaviors will be conserved across species. Hence, we detail cross-species tasks which can be used to test the effects of manipulations relevant to schizophrenia and putative therapeutics. Such tasks offer the hope of providing a bridge between non-clinical and clinical testing that will eventually lead to treatments developed specifically for patients with deficient cognition.

摘要

精神分裂症是一种终身性的使人衰弱的精神障碍,影响着全球数千万人。抗精神病药物的意外发现使药物研究集中于开发更好的抗精神病药物。然而,随着我们认识到患者需要认知增强剂来改善日常生活,我们对这种疾病的理解也有了进展。虽然抗精神病药物能治疗精神病,但它们并不能增强认知能力,因此不是抗精神分裂症药物。然而,开发促认知疗法极其困难,尤其是在没有获批治疗方法的情况下。由于没有偶然发现有效的治疗方法,通过了解患者认知功能改变背后的神经机制,有助于开发有针对性的化合物。同样重要的是,需要在动物和人类中以相似的方式测量这些认知领域,以便在进行昂贵的临床试验之前测试新的靶点。迄今为止,跨物种测试的有限相似性导致了转化瓶颈。在这篇综述中,我们强调精神分裂症是一种以异常认知行为为特征的疾病。使用具有跨物种有效性的任务来量化这些异常,将能够量化啮齿动物中类似的过程。这种方法将增加相关行为背后的神经基质在物种间保守的可能性。因此,我们详细介绍了可用于测试与精神分裂症及假定治疗方法相关的操作效果的跨物种任务。此类任务有望在非临床测试和临床测试之间架起一座桥梁,最终带来专门为认知缺陷患者开发的治疗方法。

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