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精神分裂症中的执行控制:关于儿茶酚-O-甲基转移酶(COMT)Val158Met对共病酒精和物质使用障碍的调节作用的初步研究。

Executive control in schizophrenia: a preliminary study on the moderating role of COMT Val158Met for comorbid alcohol and substance use disorders.

作者信息

Carrà Giuseppe, Nicolini Gabriella, Crocamo Cristina, Lax Annamaria, Amidani Francesca, Bartoli Francesco, Castellano Filippo, Chiorazzi Alessia, Gamba Giulia, Papagno Costanza, Clerici Massimo

机构信息

a Department of Medicine and Surgery , University of Milano Bicocca , Monza , Italy.

b Department of Psychology , University of Milano Bicocca , Milano , Italy.

出版信息

Nord J Psychiatry. 2017 Jul;71(5):332-339. doi: 10.1080/08039488.2017.1286385. Epub 2017 Feb 14.

Abstract

BACKGROUND

A functional polymorphism in the catechol-O-methyltransferase (COMT) gene (Val158Met) appears to influence cognition in people with alcohol/substance use disorders (AUD/SUD) and in those with psychosis.

METHODS

To explore the potential moderating effect of these factors, a cross-sectional study was conducted, randomly recruiting subjects with DSM-IV diagnosis of schizophrenia. AUD/SUD was rigorously assessed, as well as COMT Val158Met polymorphism. Executive control functioning was measured using the Intra-Extra Dimensional Set Shift (IED). The effect of a possible interaction between comorbid AUD/SUD and COMT Val158Met polymorphism on IED scores was explored.

RESULTS

Subjects with schizophrenia, comorbid AUD/SUD, and MetMet carriers for SNP rs4680 of the COMT gene showed worse performance on IED completed stages scores, as compared with individuals with ValVal genotype. However, among subjects without AUD/SUD, those with the MetMet variant performed better than people carrying ValVal genotype.

CONCLUSIONS

This study is the first to date examining the impact of COMT on cognition in a highly representative sample of people with schizophrenia and comorbid AUD/SUD. Differential moderating effects of COMT Val/Met genotype variations may similarly influence executive functions in people with schizophrenia and comorbid AUD/SUD.

摘要

背景

儿茶酚-O-甲基转移酶(COMT)基因中的一个功能多态性(Val158Met)似乎会影响酒精/物质使用障碍(AUD/SUD)患者以及精神病患者的认知。

方法

为探究这些因素的潜在调节作用,开展了一项横断面研究,随机招募符合《精神疾病诊断与统计手册》第四版(DSM-IV)精神分裂症诊断标准的受试者。对AUD/SUD以及COMT Val158Met多态性进行了严格评估。使用维度内-维度间转换测验(IED)来测量执行控制功能。探究了共病AUD/SUD与COMT Val158Met多态性之间可能的相互作用对IED分数的影响。

结果

与携带ValVal基因型的个体相比,患有精神分裂症、共病AUD/SUD以及COMT基因SNP rs4680的MetMet携带者在IED完成阶段分数上表现更差。然而,在没有AUD/SUD的受试者中,携带MetMet变异的个体比携带ValVal基因型的个体表现更好。

结论

本研究是首例在具有高度代表性的精神分裂症合并AUD/SUD患者样本中考察COMT对认知影响的研究。COMT Val/Met基因型变异的不同调节作用可能同样会影响精神分裂症合并AUD/SUD患者的执行功能。

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