Joseph M H, Baker H F, Johnstone E C, Crow T J
Psychopharmacology (Berl). 1976 Dec 21;51(1):47-51. doi: 10.1007/BF00426320.
On the basis of post-mortem studies it has been proposed that the central deficit in schizophrenia may be in noradrenergic transmission. It has also been proposed that there is a substantial central contribution to the excretion of the noradrenaline metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) and more particularly of its sulphate conjugate in man. There is throught to be a lesser central contribution to the excretion of the other major noradrenaline metabolites, vanillylmandelic acid (VMA) and the glucuronide conjugate of MHPG. A strong negative correlation was found between severity of illness in a group of 18 unmedicated chronic schizophrenic patients and their 24-h excretion of MHPG-sulphate but not of MHPG-glucuronide or VMA. However there was no significant difference in the mean excretion of MHPG conjugates or of VMA between the schizophrenic group and an institutional control group. This supports the idea of a relation between MHPG-sulphate excretion and central noradrenergic activity, but suggests that reduced brain noradrenaline turnover is neither necessary nor sufficient for schizophrenia to occur. One possible explanation is that reduced turnover pre-disposes towards a more severe illness in schizophrenics.
基于尸检研究，有人提出精神分裂症的核心缺陷可能在于去甲肾上腺素能传递。也有人提出，人体去甲肾上腺素代谢产物3-甲氧基-4-羟基苯乙二醇（MHPG），尤其是其硫酸盐结合物的排泄，很大程度上受中枢影响。而对于其他主要去甲肾上腺素代谢产物香草扁桃酸（VMA）和MHPG葡萄糖醛酸结合物的排泄而言，中枢的影响较小。在一组18名未接受药物治疗的慢性精神分裂症患者中，病情严重程度与他们24小时内MHPG硫酸盐的排泄量之间存在强烈的负相关，但与MHPG葡萄糖醛酸结合物或VMA的排泄量无关。然而，精神分裂症组与机构对照组之间，MHPG结合物或VMA的平均排泄量并无显著差异。这支持了MHPG硫酸盐排泄与中枢去甲肾上腺素能活性之间存在关联的观点，但表明脑内去甲肾上腺素周转率降低对于精神分裂症的发生既非必要条件也非充分条件。一种可能的解释是，周转率降低使精神分裂症患者更易罹患重症。
