Post-Doctoral Fellow, Centre for Addiction and Mental Health, Toronto, Ontario.
Koerner New Scientist and Head of Kimel-Family Translational Imaging-Genetics Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario; Assistant Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario.
Can J Psychiatry. 2014 Oct;59(10):513-7. doi: 10.1177/070674371405901003.
For over 20 years, studies have tried to measure the association between the duration of untreated psychosis (DUP) and changes in brain morphology. A hypothesis that untreated psychosis is neurotoxic has been postulated, but the mechanisms of that toxicity have not been described. We re-analyzed papers collected for a systematic review to extract data on the hypotheses that have been generated on the potential mechanisms by which DUP could impact brain morphology in first-episode psychosis. Dopaminergic hyperactivity, prolonged hypothalamic-pituitary-adrenal activation, and persistent activity of catecholamines have been hypothesized as mechanisms to explain these associations. However, the question remains as to whether the observed structural changes are permanent or may be reversed via antipsychotic treatment.
二十多年来，研究一直试图衡量未治疗精神病持续时间（DUP）与大脑形态变化之间的关联。有人假设未经治疗的精神病具有神经毒性，但尚未描述这种毒性的机制。我们重新分析了为系统评价收集的论文，以提取有关假设的信息，这些假设涉及 DUP 如何影响首发精神病患者的大脑形态的潜在机制。多巴胺能过度活跃、下丘脑-垂体-肾上腺激活时间延长以及儿茶酚胺持续活性被假设为解释这些关联的机制。然而，目前仍存在一个问题，即观察到的结构变化是永久性的，还是可以通过抗精神病治疗逆转。
