Issa F, Kirch D G, Gerhardt G A, Bartko J J, Suddath R L, Freedman R, Wyatt R J
Neuropsychiatry Branch, National Institute of Mental Health, Washington, DC 20032.
Psychiatry Res. 1994 Jun;52(3):251-8. doi: 10.1016/0165-1781(94)90070-1.
As part of a multidimensional study of cerebrospinal fluid biogenic amine metabolites in schizophrenia, the relationship between neurochemical measures and psychopathology assessed using the Psychiatric Symptom Assessment Scale (PSAS) was analyzed. In a group of 20 unmedicated patients, 3,4-dihydroxyphenylacetic acid (DOPAC) was a predictor of symptom severity in a stepwise multiple regression model. Values of 3-hydroxykynurenine and metanephrine in the unmedicated state predicted clinical response in a stepwise multiple regression model, as measured by improvement in PSAS mean item score following 6 weeks on a standard dose of neuroleptic. In a subgroup of 14 patients in whom both off- and on-medication concentrations of cerebrospinal fluid biogenic amines and metabolites were measured, change in 3-hydroxykynurenine predicted clinical outcome in a multiple regression model. These findings point toward the need to examine the role of the kynurenine pathway of tryptophan metabolism in the pathophysiology of schizophrenia.
作为对精神分裂症患者脑脊液生物胺代谢产物进行多维研究的一部分，分析了使用精神症状评估量表（PSAS）评估的神经化学指标与精神病理学之间的关系。在一组20名未服药的患者中，在逐步多元回归模型中，3,4-二羟基苯乙酸（DOPAC）是症状严重程度的预测指标。在逐步多元回归模型中，未服药状态下的3-羟基犬尿氨酸和间甲肾上腺素的值可预测临床反应，临床反应通过标准剂量抗精神病药物治疗6周后PSAS平均项目得分的改善来衡量。在一个亚组的14名患者中，同时测量了脑脊液生物胺和代谢产物的服药前和服药后浓度，在多元回归模型中，3-羟基犬尿氨酸的变化可预测临床结果。这些发现表明有必要研究色氨酸代谢的犬尿氨酸途径在精神分裂症病理生理学中的作用。
