Cassady S L, Thaker G K, Tamminga C A
Maryland Psychiatric Research Center, Catonsville 21228.
Psychopharmacol Bull. 1993;29(2):235-40.
Abnormalities in saccadic eye movements have been found in schizophrenics with tardive dyskinesia (TD). This finding supports accumulating evidence for a GABAergic dysfunction in the subcortical-cortical circuits controlling motor and oculomotor behavior. We found that in response to muscimol, a direct-acting GABA agonist, changes in the antisaccade error rate and dyskinesia score were strongly correlated. We then looked at the relationship between these measures during single-blind haloperidol withdrawal. Significant changes occurred in antisaccade error during drug withdrawal, but the final measure was not significantly different from the baseline assessment. Antisaccade error change scores were not correlated with dyskinesia change scores. Change score in antisaccade error was positively correlated with change on the Brief Psychiatric Rating Scale, specifically with the Anxiety/Depression factor. These findings suggest that GABAergic mechanisms are more robust than dopaminergic mechanisms in the pathophysiology of persistent tardive dyskinesia.
在患有迟发性运动障碍(TD)的精神分裂症患者中发现了眼球扫视运动异常。这一发现支持了越来越多的证据,即控制运动和眼球运动行为的皮层下 - 皮层回路中存在GABA能功能障碍。我们发现,对直接作用的GABA激动剂蝇蕈醇的反应中,反扫视错误率的变化与运动障碍评分密切相关。然后,我们观察了单盲停用氟哌啶醇期间这些指标之间的关系。停药期间反扫视错误出现了显著变化,但最终测量结果与基线评估无显著差异。反扫视错误变化分数与运动障碍变化分数不相关。反扫视错误变化分数与简明精神病评定量表的变化呈正相关,特别是与焦虑/抑郁因子相关。这些发现表明,在持续性迟发性运动障碍的病理生理学中,GABA能机制比多巴胺能机制更稳健。