Györfi Orsolya, Nagy Helga, Bokor Magdolna, Kelemen Oguz, Kéri Szabolcs
Neurology Department, Nyírő Gyula Hospital-National Institute of Psychiatry and Addictions, Budapest, Hungary.
National Institute for Medical Rehabilitation, Budapest, Hungary.
J Neural Transm (Vienna). 2017 Jan;124(1):113-119. doi: 10.1007/s00702-016-1630-6. Epub 2016 Oct 7.
Despite the well-known neuropsychiatric side effects of dopaminergic medications, the possible subjective psychotomimetic effects of a single dose of L-DOPA in newly diagnosed, drug-naïve patients with Parkinson's disease (PD) are not known. To investigate this question, we used a visual search task for latent inhibition (LI), the Community Assessment of Psychic Experiences (CAPE) scale, and visual analog scales for psychotomimetic effects (perception, relaxation, and dysphoria) in 28 de novo PD patients before (off) and after (on) the adminstration of L-DOPA and in 25 matched healthy control individuals. Results revealed increased LI in PD-off and decreased LI in PD-on relative to the control subjects. After the administration of L-DOPA, we observed a significant decline in LI in PD. L-DOPA also enhanced perceptual experiences (changes in subjective feelings in thinking, time perception, and mental "highness"). Greater reduction in LI was associated with enhanced perceptual experiences. These results suggest that a single dose of L-DOPA has a significant psychotomimetic effect, which is associated with decreased LI, a behavioral marker of psychosis-like experiences.
尽管多巴胺能药物存在众所周知的神经精神副作用,但单剂量左旋多巴(L-DOPA)对新诊断的、未服用过药物的帕金森病(PD)患者可能产生的主观拟精神病效应尚不清楚。为了研究这个问题,我们在28例初发PD患者服用L-DOPA之前(未服药状态)和之后(服药状态),以及25名匹配的健康对照个体中,使用了视觉搜索任务来检测潜在抑制(LI)、精神体验社区评估(CAPE)量表以及拟精神病效应的视觉模拟量表(感知、放松和烦躁不安)。结果显示,与对照组相比,未服药的PD患者LI增加,服药的PD患者LI降低。服用L-DOPA后,我们观察到PD患者的LI显著下降。L-DOPA还增强了感知体验(思维、时间感知和精神“兴奋感”方面的主观感受变化)。LI的更大降低与增强的感知体验相关。这些结果表明,单剂量L-DOPA具有显著的拟精神病效应,这与LI降低有关,LI是类似精神病体验的行为标志物。