Krebs M O
Service hospitalo-universitaire de Santé mentale, Hôpital Sainte-Anne, Paris.
Encephale. 1995 Sep-Oct;21(5):581-8.
Glutamatergic hypothesis stemmed from the observation of phencyclidine-induced psychosis. Phencyclidine is able to induce in healthy subjects negative and positive schizophrenic-like symptoms, as well as thought disorganization. Phencyclidine acts as an antagonist of NMDA receptor, one of the glutamatergic receptors. Experimental studies in animals have demonstrated that compartmental effect of phencyclidine is due to its action at striatal level, allowing the disinhibition of down-stream structures. The organization of the two striato-thalamocortical loops, which exert, respectively, a positive and negative retro-control on cortical activity, may explain how a glutamatergic deficiency induces both positive and negative symptoms. Positive symptoms could also be due to a secondary hyperdopaminergia, since a part of striatum, the striosomes, connected with limbic system, control the activity of dopaminergic neurons. This model validates the hypothesis that a single anomaly can lead to the different symptomatic dimensions of schizophrenia and supports the implication of basal ganglia in the expression of mental disease.
谷氨酸能假说源于对苯环己哌啶诱发精神病的观察。苯环己哌啶能够在健康受试者中诱发阴性和阳性精神分裂症样症状以及思维紊乱。苯环己哌啶作为谷氨酸能受体之一的N-甲基-D-天冬氨酸(NMDA)受体的拮抗剂。动物实验研究表明,苯环己哌啶的分隔效应是由于其在纹状体水平的作用,使得下游结构的去抑制。两个纹状体-丘脑-皮质环路的组织,分别对皮质活动发挥正向和负向的逆向控制,这可能解释了谷氨酸能缺乏如何诱发阳性和阴性症状。阳性症状也可能归因于继发性多巴胺能亢进,因为纹状体的一部分,即与边缘系统相连的纹状体小体,控制着多巴胺能神经元的活动。该模型验证了单一异常可导致精神分裂症不同症状维度的假说,并支持基底神经节在精神疾病表达中的作用。