Hartmann J, Künig G, Riederer P
Department of Psychiatry, University of Würzburg, Germany.
Acta Neurol Scand Suppl. 1993;146:18-21.
Normal function of the central nervous system (CNS) requires intact morphology as well as neurotransmission. Diseases of the CNS can become manifest as a sensorimotor deficit or psychic alteration, or both. When observing neuropsychiatric diseases, interaction of different transmitter systems is obvious. Thus, an increase or a decrease of transmitter systems affect each other. Mechanisms of compensation can also lead to alterations in transmitter systems not involved in the pathological process. Parkinson's disease, hyperkinetic movement disorders like ballism and Huntington's chorea, epilepsy and anxiety will be used in this paper as examples of the synergistic action of dopaminergic, peptidergic, glutamatergic, GABAergic and cholinergic neurotransmission. With our knowledge of the functional balance of transmitter systems in the CNS, various pharmacological strategies have been available to intervene in the pathophysiological process. The excitatory or inhibitory quality of the transmitter systems must be considered if such strategies are to be employed. On the other hand, a functional balance between two or more transmitter systems may cause a contrary therapeutic intervention on the opposite side of the balance.
中枢神经系统（CNS）的正常功能需要完整的形态以及神经传递。中枢神经系统疾病可表现为感觉运动缺陷或精神改变，或两者皆有。在观察神经精神疾病时，不同递质系统之间的相互作用显而易见。因此，递质系统的增加或减少会相互影响。代偿机制也可导致未参与病理过程的递质系统发生改变。本文将帕金森病、像投掷症和亨廷顿舞蹈症这样的运动亢进性疾病、癫痫和焦虑症作为多巴胺能、肽能、谷氨酸能、γ-氨基丁酸能和胆碱能神经传递协同作用的例子。基于我们对中枢神经系统递质系统功能平衡的了解，已经有了各种药理学策略来干预病理生理过程。如果要采用这些策略，必须考虑递质系统的兴奋或抑制性质。另一方面，两个或更多递质系统之间的功能平衡可能会在平衡的另一侧引起相反的治疗干预。
