Egerton A, Modinos G, Ferrera D, McGuire P
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Serviço de Psiquiatria e Saúde Mental, Departamento de Neurociências e Saúde Mental, Hospital de Santa Maria EPE, Lisboa, Portugal.
Transl Psychiatry. 2017 Jun 6;7(6):e1147. doi: 10.1038/tp.2017.124.
Data from animal models and from postmortem studies suggest that schizophrenia is associated with brain GABAergic dysfunction. The extent to which this is reflected in data from in vivo studies of GABA function in schizophrenia is unclear. The Medline database was searched to identify articles published until 21 October 2016. The search terms included GABA, proton magnetic resonance spectroscopy (H-MRS), positron emission tomography (PET), single photon emission computed tomography (SPECT), schizophrenia and psychosis. Sixteen GABA H-MRS studies (538 controls, 526 patients) and seven PET/SPECT studies of GABA/benzodiazepine receptor (GABA/BZR) availability (118 controls, 113 patients) were identified. Meta-analyses of H-MRS GABA in the medial prefrontal cortex (mPFC), parietal/occipital cortex (POC) and striatum did not show significant group differences (mFC: g=-0.3, 409 patients, 495 controls, 95% confidence interval (CI): -0.6 to 0.1; POC: g=-0.3, 139 patients, 111 controls, 95% CI: -0.9 to 0.3; striatum: g=-0.004, 123 patients, 95 controls, 95% CI: -0.7 to 0.7). Heterogeneity across studies was high (I>50%), and this was not explained by subsequent moderator or meta-regression analyses. There were insufficient PET/SPECT receptor availability studies for meta-analyses, but a systematic review did not suggest replicable group differences in regional GABA/BZR availability. The current literature does not reveal consistent alterations in in vivo GABA neuroimaging measures in schizophrenia, as might be hypothesized from animal models and postmortem data. The analysis highlights the need for further GABA neuroimaging studies with improved methodology and addressing potential sources of heterogeneity.
来自动物模型和尸检研究的数据表明，精神分裂症与脑内γ-氨基丁酸（GABA）能功能障碍有关。然而，这在精神分裂症患者GABA功能的体内研究数据中体现的程度尚不清楚。检索了Medline数据库，以识别截至2016年10月21日发表的文章。检索词包括GABA、质子磁共振波谱（H-MRS）、正电子发射断层扫描（PET）、单光子发射计算机断层扫描（SPECT）、精神分裂症和精神病。共识别出16项GABA H-MRS研究（538名对照，526名患者）以及7项关于GABA/苯二氮䓬受体（GABA/BZR）可用性的PET/SPECT研究（118名对照，113名患者）。对内侧前额叶皮质（mPFC）、顶叶/枕叶皮质（POC）和纹状体中H-MRS检测的GABA进行的荟萃分析未显示出显著的组间差异（mPFC：g=-0.3，409名患者，495名对照，95%置信区间（CI）：-0.6至0.1；POC：g=-0.3，139名患者，111名对照，95%CI：-0.9至0.3；纹状体：g=-0.004，123名患者，95名对照，95%CI：-0.7至0.7）。研究间的异质性较高（I>50%），后续的调节因素分析或荟萃回归分析均无法解释这一现象。PET/SPECT受体可用性研究的数量不足以进行荟萃分析，但一项系统评价并未提示在区域GABA/BZR可用性方面存在可重复的组间差异。正如动物模型和尸检数据所推测的那样，当前文献并未揭示精神分裂症患者体内GABA神经影像学测量结果存在一致的改变。该分析强调了需要采用改进的方法并解决潜在的异质性来源，进一步开展GABA神经影像学研究。
