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患有重度抑郁症的服药患者和未服药患者的视网膜电图异常:探寻主要精神疾病的发育根源

Electroretinographic anomalies in medicated and drug free patients with major depression: Tagging the developmental roots of major psychiatric disorders.

作者信息

Hébert Marc, Mérette Chantal, Paccalet Thomas, Gagné Anne-Marie, Maziade Michel

机构信息

Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada; Département d'ophtalmologie et ORL - chirurgie cervico-faciale, Université Laval, Québec, Canada.

Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada; Département de psychiatrie et neurosciences, Université Laval, Québec, Canada.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2017 Apr 3;75:10-15. doi: 10.1016/j.pnpbp.2016.12.002. Epub 2016 Dec 19.

Abstract

The retina is tagged as an approachable part of the brain due to its common embryonic origin and appears as a promising site of investigation for psychiatric disorders. Retinal function is assessed best with the electroretinogram (ERG), which was obtained in a large sample of patients with major depressive disorder and matched controls. ERG cone and rod luminance response functions were recorded in non-dilated eyes in 100 major depressive disorder patients (MDD) and 100 controls, (mean age of 42.8 and 40.9y. o. respectively). Amongst MDD patients, 17 were drug free (mean age 41.2y. o). In medicated patients, at the cone level, a prolonged b-wave was observed (p≤0.01). In drug free patients a prolonged b-wave was discovered only when averaging the implicit time of the 3 highest b-wave amplitudes of the photopic hill. For the medicated patients, the mixed rods/cones a-wave was reduced (p=0.01) whereas a trend (p=0.06) was observed for the pure rod b-wave (reduced) and the mixed rods/cones (reduced and prolonged; p=0.05). In drug free patients, a similar pattern could be observed in terms of effect sizes. Overall, medicated and drug free MDD patients shared some deficits suggesting that some anomalies are present above and beyond the effect of medication. Of interest, the prolonged cone and reduced rod amplitude were reported by our group in schizophrenia patients, suggesting a common neurodevelopmental root of major psychiatric disorders.

摘要

由于视网膜与大脑有着共同的胚胎起源,它被视为大脑中易于研究的部分,并且似乎是精神疾病研究的一个有前景的部位。视网膜功能最好通过视网膜电图(ERG)来评估,该测试在一大群重度抑郁症患者及匹配的对照组中进行。对100名重度抑郁症患者(MDD)和100名对照组(平均年龄分别为42.8岁和40.9岁)的未散瞳眼睛记录了ERG视锥和视杆亮度反应功能。在MDD患者中,17名未服用药物(平均年龄41.2岁)。在服用药物的患者中,在视锥水平观察到b波延长(p≤0.01)。在未服用药物的患者中,仅在对明视峰的3个最高b波振幅的潜伏时间进行平均时才发现b波延长。对于服用药物的患者,混合视杆/视锥a波降低(p = 0.01),而对于纯视杆b波(降低)和混合视杆/视锥(降低且延长;p = 0.05)观察到一种趋势(p = 0.06)。在未服用药物的患者中,就效应大小而言可以观察到类似的模式。总体而言,服用药物和未服用药物的MDD患者存在一些共同的缺陷,这表明一些异常情况在药物作用之外也存在。有趣的是,我们团队在精神分裂症患者中也报告了视锥延长和视杆振幅降低的情况,这表明主要精神疾病存在共同的神经发育根源。

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