Strzelecki Dominik, Grzelak Piotr, Podgórski Michał, Kałużyńska Olga, Stefańczyk Ludomir, Kotlicka-Antczak Magdalena, Gmitrowicz Agnieszka
Department of Affective and Psychotic Disorders, Medical University of Łódź, Central Clinical Hospital, Łódź 92-213, Poland.
Department of Radiology-Diagnostic Imaging, Medical University of Łódź, Barlicki University Hospital No. 1, Łódź 90-153, Poland.
Int J Mol Sci. 2015 Oct 15;16(10):24387-402. doi: 10.3390/ijms161024387.
Managing affective, negative, and cognitive symptoms remains the most difficult therapeutic problem in stable phase of schizophrenia. Efforts include administration of antidepressants. Drugs effects on brain metabolic parameters can be evaluated by means of proton nuclear magnetic resonance (¹H-NMR) spectroscopy. We compared spectroscopic parameters in the left prefrontal cortex (DLPFC), the left frontal white matter (WM) and the left hippocampus and assessed the relationship between treatment and the spectroscopic parameters in both groups. We recruited 25 patients diagnosed with schizophrenia (DSM-IV-TR), with dominant negative symptoms and in stable clinical condition, who were treated with antipsychotic and antidepressive medication for minimum of three months. A group of 25 patients with schizophrenia, who were taking antipsychotic drugs but not antidepressants, was matched. We compared metabolic parameters (N-acetylaspartate (NAA), myo-inositol (mI), glutamatergic parameters (Glx), choline (Cho), and creatine (Cr)) between the two groups. All patients were also assessed with the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS). In patients receiving antidepressants we observed significantly higher NAA/Cr and NAA/Cho ratios within the DLPFC, as well as significantly higher mI/Cr within the frontal WM. Moreover, we noted significantly lower values of parameters associated with the glutamatergic transmission--Glx/Cr and Glx/Cho in the hippocampus. Doses of antipsychotic drugs in the group treated with antidepressants were also significantly lower in the patients showing similar severity of psychopathology.
在精神分裂症稳定期，管理情感、阴性和认知症状仍然是最困难的治疗问题。治疗措施包括使用抗抑郁药。药物对脑代谢参数的影响可通过质子核磁共振（¹H-NMR）波谱法进行评估。我们比较了左侧前额叶皮质（背外侧前额叶皮质）、左侧额叶白质和左侧海马的波谱参数，并评估了两组治疗与波谱参数之间的关系。我们招募了25名被诊断为精神分裂症（DSM-IV-TR）、以阴性症状为主且临床状况稳定的患者，他们接受抗精神病药和抗抑郁药治疗至少三个月。匹配了一组25名正在服用抗精神病药物但未服用抗抑郁药的精神分裂症患者。我们比较了两组之间的代谢参数（N-乙酰天门冬氨酸（NAA）、肌醇（mI）、谷氨酸能参数（Glx）、胆碱（Cho）和肌酸（Cr））。所有患者还使用阳性和阴性症状量表（PANSS）和卡尔加里精神分裂症抑郁量表（CDSS）进行评估。在接受抗抑郁药治疗的患者中，我们观察到背外侧前额叶皮质内NAA/Cr和NAA/Cho比值显著更高，以及额叶白质内mI/Cr显著更高。此外，我们注意到海马中与谷氨酸能传递相关的参数——Glx/Cr和Glx/Cho的值显著更低。在精神病理学严重程度相似的患者中，接受抗抑郁药治疗组的抗精神病药物剂量也显著更低。
