Miller D D, Rezai K, Alliger R, Andreasen N C
Department of Psychiatry, University of Iowa Hospital and Clinics, University of Iowa College of Medicine, Iowa City 52242-1057, USA.
Biol Psychiatry. 1997 Mar 1;41(5):550-9. doi: 10.1016/s0006-3223(96)00110-2.
Functional neuroimaging studies in schizophrenia have often been confounded by various factors including medication status. To explore the effects of antipsychotic medications on relative regional cerebral perfusion, we scanned a group of 33 persons with schizophrenia twice, while receiving a stable dose of antipsychotic and after being off antipsychotics for 3 weeks, using technetium-99m hexamethyl-propyleneamine oxime single photon emission computed tomography (Tc-99m HMPAO-SPECT. We found that antipsychotic significantly increased the mean relative cerebral perfusion in the left basal ganglia. Additionally, patients receiving thiothixene (n = 9) had a significantly greater increase in relative cerebral perfusion in the basal ganglia than patients receiving haloperidol (n = 12). These findings indicate that antipsychotics lead to regional increases in cerebral perfusion and that antipsychotic status must be controlled for in functional neuroimaging studies. Functional neuroimaging techniques such as SPECT may be useful in furthering our understanding of the mechanism of antipsychotics.
精神分裂症的功能性神经影像学研究常常受到包括用药状态在内的各种因素的干扰。为了探究抗精神病药物对相对局部脑灌注的影响，我们对一组33名精神分裂症患者进行了两次扫描，一次是在接受稳定剂量抗精神病药物治疗时，另一次是在停用抗精神病药物3周后，使用锝-99m六甲基丙烯胺肟单光子发射计算机断层扫描（Tc-99m HMPAO-SPECT）。我们发现，抗精神病药物显著增加了左侧基底神经节的平均相对脑灌注。此外，接受硫利达嗪（n = 9）治疗的患者基底神经节相对脑灌注的增加显著大于接受氟哌啶醇（n = 12）治疗的患者。这些发现表明，抗精神病药物会导致脑灌注的局部增加，并且在功能性神经影像学研究中必须控制抗精神病药物状态。诸如SPECT之类的功能性神经影像学技术可能有助于加深我们对抗精神病药物作用机制的理解。
