Mackintosh Amatya Johanna, de Bock Renate, Lim Zehwi, Trulley Valerie-Noelle, Schmidt André, Borgwardt Stefan, Andreou Christina
University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 60/62, 4055 Basel, Switzerland.
University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland.
Neurosci Biobehav Rev. 2021 Jan;120:354-371. doi: 10.1016/j.neubiorev.2020.10.021. Epub 2020 Nov 7.
Both dysconnectivity and dopamine hypotheses are two well researched pathophysiological models of psychosis. However, little is known about the association of dopamine dysregulation with brain functional connectivity in psychotic disorders, specifically through the administration of antipsychotic medication. In this systematic review, we summarize the existing evidence on the association of dopaminergic effects with electro- and magnetoencephalographic (EEG/MEG) resting-state brain functional connectivity assessed by sensor- as well as source-level measures. A wide heterogeneity of results was found amongst the 20 included studies with increased and decreased functional connectivity in medicated psychosis patients vs. healthy controls in widespread brain areas across all frequency bands. No systematic difference in results was seen between studies with medicated and those with unmedicated psychosis patients and very few studies directly investigated the effect of dopamine agents with a pre-post design. The reported evidence clearly calls for longitudinal EEG and MEG studies with large participant samples to directly explore the association of antipsychotic medication effects with neural network changes over time during illness progression and to ultimately support the development of new treatment strategies.
失连接性假说和多巴胺假说都是对精神病进行了充分研究的病理生理模型。然而,关于多巴胺调节异常与精神障碍中脑功能连接性之间的关联,尤其是通过抗精神病药物给药后的关联,我们所知甚少。在这项系统综述中,我们总结了关于多巴胺能效应与通过传感器及源水平测量评估的静息态脑电(EEG)和脑磁图(MEG)脑功能连接性之间关联的现有证据。在纳入的20项研究中发现了广泛的结果异质性,在所有频段的广泛脑区中,与健康对照相比,药物治疗的精神病患者的功能连接性增加和减少。在使用药物治疗的精神病患者的研究和未使用药物治疗的精神病患者的研究之间,未观察到结果上的系统差异,并且很少有研究采用前后设计直接研究多巴胺能药物的作用。所报告的证据显然需要进行具有大量参与者样本的纵向EEG和MEG研究,以直接探索抗精神病药物治疗效果与疾病进展过程中神经网络随时间变化之间的关联,并最终支持新治疗策略的开发。