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电抽搐治疗后抵抗治疗的精神分裂症患者的神经生长因子血清水平。

Nerve growth factor serum levels in treatment-resistant schizophrenic patients following electroconvulsive therapy.

机构信息

Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila.

Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome.

出版信息

Clin Ter. 2021 Jan-Feb;171(1):e67-e74. doi: 10.7417/CT.2021.2286.

Abstract

BACKGROUND

Electroconvulsive Therapy (ECT) has been widely applied to treat schizophrenia (SCZ) in the presence of resistance to pharmacotherapy. The mechanism of action of ECT in schizophrenia has not been fully clarified, though its intrinsic mechanism presents analogies with some neurobiological processes mediated by nerve growth factor (NGF).

OBJECTIVES

The aim of this study was to investigate in patients with treatment-resistant schizophrenia (TRS) the effect of ECT on acute and long-term NGF serum levels and the association with the clinical outcomes.

METHODS

Twelve male inpatients with TRS underwent eight sessions of ECT. Blood samples were collected during the first and the eighth ECT at the following time points: 5 minutes before the induction of seizure and then at 0, 5, 15 and 30 minutes after seizure.

RESULTS

Following ECT treatment, a substantial clinical improvement in symptom severity was indicated by a significant reduction in the Positive and Negative Syndrome Scale (PANSS) total and subscales scores. Even though the baseline NGF levels showed an increase over time, there were no statistical differences in NGF at time 0 at the first and the eighth ECT session. Furthermore, no correlation was observed between the severity of schizophrenic symptoms and NGF levels.

CONCLUSIONS

This is the first study addressing peripheral NGF during ECT treatment in TRS, as well as the first study in which NGF has been evaluated in different ECT sessions at various time points. These findings may potentiate the knowledge about the neurotrophic effects of ECT and the role of NGF in synaptic plasticity related to possible mechanisms of schizophrenia treatment.

摘要

背景

电抽搐疗法(ECT)已广泛应用于治疗对药物治疗有抗药性的精神分裂症(SCZ)。尽管 ECT 的作用机制与神经生长因子(NGF)介导的某些神经生物学过程具有相似性,但它在精神分裂症中的作用机制尚未完全阐明。

目的

本研究旨在探讨电抽搐治疗对治疗抵抗性精神分裂症(TRS)患者急性和长期血清 NGF 水平的影响及其与临床结果的关系。

方法

12 名男性 TRS 住院患者接受了 8 次 ECT。在首次和第八次 ECT 期间,在以下时间点采集血液样本:在诱导癫痫发作前 5 分钟,然后在癫痫发作后 0、5、15 和 30 分钟。

结果

ECT 治疗后,阳性和阴性症状量表(PANSS)总分和子量表评分显著降低,表明症状严重程度有明显改善。尽管 NGF 水平随时间推移而增加,但在第一次和第八次 ECT 时,在时间 0 时 NGF 无统计学差异。此外,精神分裂症症状严重程度与 NGF 水平之间没有相关性。

结论

这是第一项关于 TRS 中 ECT 治疗期间外周 NGF 的研究,也是第一项评估不同 ECT 时间点不同 ECT 时 NGF 的研究。这些发现可能有助于了解 ECT 的神经营养作用以及 NGF 在与精神分裂症治疗可能机制相关的突触可塑性中的作用。

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