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将精神分裂症分子基础研究的进展转化为新的认知治疗策略。

Translating advances in the molecular basis of schizophrenia into novel cognitive treatment strategies.

机构信息

School of Medicine, University College Cork, Brookfield Health Sciences Complex, Cork, Ireland.

School of Psychology, University of Nottingham, Nottingham, UK.

出版信息

Br J Pharmacol. 2017 Oct;174(19):3173-3190. doi: 10.1111/bph.13938. Epub 2017 Aug 3.

Abstract

The presence and severity of cognitive symptoms, including working memory, executive dysfunction and attentional impairment, contributes materially to functional impairment in schizophrenia. Cognitive symptoms have proved to be resistant to both first- and second-generation antipsychotic drugs. Efforts to develop a consensus set of cognitive domains that are both disrupted in schizophrenia and are amenable to cross-species validation (e.g. the National Institute of Mental Health Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia and Research Domain Criteria initiatives) are an important step towards standardization of outcome measures that can be used in preclinical testing of new drugs. While causative genetic mutations have not been identified, new technologies have identified novel genes as well as hitherto candidate genes previously implicated in the pathophysiology of schizophrenia and/or mechanisms of antipsychotic efficacy. This review comprises a selective summary of these developments, particularly phenotypic data arising from preclinical genetic models for cognitive dysfunction in schizophrenia, with the aim of indicating potential new directions for pro-cognitive therapeutics. Linked Articles This article is part of a themed section on Pharmacology of Cognition: a Panacea for Neuropsychiatric Disease? To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.19/issuetoc.

摘要

认知症状的存在和严重程度,包括工作记忆、执行功能和注意力损害,对精神分裂症的功能损害有重要贡献。认知症状已被证明对第一代和第二代抗精神病药物均具有抗性。努力制定一套共识认知领域,这些领域在精神分裂症中受到干扰,并且可以进行跨物种验证(例如,国立精神卫生研究所认知神经科学治疗研究以改善精神分裂症的认知和研究领域标准倡议)是朝着标准化的方向迈出的重要一步,这些标准可以用于新药物的临床前测试。虽然尚未确定致病基因突变,但新技术已经确定了新的基因以及以前与精神分裂症的病理生理学和/或抗精神病药物疗效机制有关的以前的候选基因。这篇综述特别总结了这些发展,特别是来自精神分裂症认知功能障碍的临床前遗传模型的表型数据,旨在为认知治疗指明潜在的新方向。

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