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药物精神病学中的诱发电位。

The evoked potential in pharmacopsychiatry.

作者信息

Saletu B

出版信息

Neuropsychobiology. 1977;3(2-3):75-104. doi: 10.1159/000117593.

Abstract

Somatosensory, visual and auditory evoked potentials (EP) were recorded in different psychatric populations before as well as during psychotropic drug treatment. Drug-free schizophrenic patients showed shorter latencies, smaller amplitudes and an increased intraindividual variability in their EP than controls. Psychotic children but also children of schizophrenic mothers (so-called high-risk children) exhibited similar differences as compared to controls, suggesting a CNS overarousal as the pathoneurophysiological substrate of schizophrenia. Shorter latencies were also seen in children of psychopathic fathers. Regression and correlation analysis of psychopathological and EP measurements in hyperkinetic children revealed the following findings: the shorter the latencies and the higher the amplitudes, the sicker was the child. During psychopharmacotherapy, significant changes occurred in the EP measurements, which were found to be significantly correlated with clinical improvement or deterioration. Neuroleptics induced a latency increase and an amplitude decrease in schizophrenic patients and psychotic children. Interestingly, amphetamine produced in hyperkinetic children a latency increase too, thus explaining the 'paradoxical' clinical response to amphetamine observed in these children. Differences between therapy-responsive and therapy-resistant patients are described and, finally, some data concerning the role of the pretreatment EP as a predictor of therapeutic outcome are discussed.

摘要

在不同精神疾病患者群体中,于精神药物治疗前及治疗期间记录体感、视觉和听觉诱发电位(EP)。未服用药物的精神分裂症患者与对照组相比,其EP潜伏期更短、波幅更小且个体内变异性增加。患有精神病的儿童以及精神分裂症母亲的子女(所谓的高危儿童)与对照组相比也表现出类似差异,提示中枢神经系统过度兴奋是精神分裂症的病理神经生理基础。在有精神病态父亲的子女中也观察到较短的潜伏期。对多动症儿童的精神病理学和EP测量进行回归及相关分析得出以下结果:潜伏期越短、波幅越高,儿童病情越严重。在精神药物治疗期间,EP测量出现显著变化,且这些变化与临床改善或恶化显著相关。抗精神病药物使精神分裂症患者和患有精神病的儿童潜伏期延长、波幅降低。有趣的是,苯丙胺也使多动症儿童潜伏期延长,从而解释了在这些儿童中观察到的对苯丙胺的“矛盾”临床反应。描述了治疗反应性和治疗抵抗性患者之间的差异,最后讨论了一些关于治疗前EP作为治疗结果预测指标作用的数据。

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