Halberstadt A L
University of Delaware, Newark, USA.
Clin Neuropharmacol. 1995 Jun;18(3):237-49. doi: 10.1097/00002826-199506000-00004.
For the past 20 years, it has been widely assumed that schizophrenia results from chronic dopamine (DA) hyperactivity. However large amounts of evidence exist that call into question this assumption. After examining the brains of schizophrenic patients, studies failed to find evidence of elevated levels of DA, alterations in DA-producing or degrading enzymes or both, or increased DA-receptor concentrations or affinity; thus, there are no direct observations linking psychosis to increases in DA activity. Therefore, it seems that mechanisms unrelated to altered dopaminergic functioning may be involved in the underlying pathology of schizophrenia. The anesthetic drug phencyclidine (PCP) is capable of inducing psychosis-like states through nondopaminergic mechanisms. PCP acts as a glutamate antagonist; glutamatergic abnormalities have been detected in the brains of schizophrenics. This evidence suggest that glutamate hypofunction may be involved in the pathology of psychosis. Additionally, a functional link exists between glutamate and DA neural systems. Based on these facts, as well as an extensive review of the literature, it is concluded that dysfunctional glutamatergic pathways are involved in psychotic pathology.
在过去20年里,人们普遍认为精神分裂症是由慢性多巴胺(DA)功能亢进引起的。然而,大量证据对这一假设提出了质疑。在检查精神分裂症患者的大脑后,研究未能找到DA水平升高、DA生成或降解酶的改变或两者皆有、或DA受体浓度或亲和力增加的证据;因此,没有直接观察结果将精神病与DA活性增加联系起来。所以,似乎与多巴胺能功能改变无关的机制可能参与了精神分裂症的潜在病理过程。麻醉药物苯环己哌啶(PCP)能够通过非多巴胺能机制诱导类似精神病的状态。PCP作为一种谷氨酸拮抗剂;在精神分裂症患者的大脑中已检测到谷氨酸能异常。这一证据表明谷氨酸功能减退可能参与了精神病的病理过程。此外,谷氨酸和DA神经系统之间存在功能联系。基于这些事实以及对文献的广泛综述,得出的结论是功能失调的谷氨酸能通路参与了精神病的病理过程。