Steinberg B J, Trestman R, Mitropoulou V, Serby M, Silverman J, Coccaro E, Weston S, de Vegvar M, Siever L J
Mt. Sinai School of Medicine, New York, NY, USA.
Neuropsychopharmacology. 1997 Oct;17(4):264-73. doi: 10.1016/S0893-133X(97)00051-1.
The purpose of this study was to examine the relationship between mood and hormonal responses to cholinergic challenge with physostigmine in order to assess cholinergic system responsiveness in borderline personality disorder (BPD) patients, other non-BPD personality disorder patients, and normal controls. Thirty-four personality disorder patients, 10 of whom met criteria for BPD and 24 of whom met criteria for other, non-borderline, personality disorders, and 11 normal controls participated in a double blind, placebo controlled physostigmine challenge paradigm. The Profile of Mood States depression subscale (POMS-D) self report measure was obtained at baseline and following the physostigmine or placebo infusions. A repeated measures ANOVA of POMS-D scores in placebo and drug conditions indicated a significantly greater depressive response in the total cohort of personality disorder patients than in the normal comparison group (p < 0.05). However, the depressive response to physostigmine was significantly greater in BPD patients, but not other personality disorder patients, compared to normal controls (p < 0.05). There was a correlation between the peak placebo-corrected depressive response to physostigmine and a group of BPD traits related to affective instability but not a group of BPD traits related to impulsivity. There was no correlation in any group between mood response to physostigmine and changes in plasma cortisol, prolactin, or growth hormone, or to nausea or other side effects following physostigmine infusion. These data suggest that there is an association between BPD and acute depressive responses to physostigmine challenge, and that the cholinergic system may be involved in the regulation of affect in Axis II disorders.
本研究的目的是探讨情绪与毒扁豆碱对胆碱能激发的激素反应之间的关系，以便评估边缘型人格障碍（BPD）患者、其他非BPD人格障碍患者和正常对照者的胆碱能系统反应性。34名人格障碍患者（其中10名符合BPD标准，24名符合其他非边缘型人格障碍标准）和11名正常对照者参与了一项双盲、安慰剂对照的毒扁豆碱激发试验。在基线以及毒扁豆碱或安慰剂输注后，采用情绪状态剖面图抑郁分量表（POMS-D）进行自我报告测量。对安慰剂组和药物组的POMS-D评分进行重复测量方差分析，结果表明，人格障碍患者总体队列中的抑郁反应显著大于正常对照组（p < 0.05）。然而，与正常对照相比，BPD患者对毒扁豆碱的抑郁反应显著更大，但其他人格障碍患者并非如此（p < 0.05）。毒扁豆碱校正后的安慰剂峰值抑郁反应与一组与情感不稳定相关的BPD特质之间存在相关性，但与一组与冲动性相关的BPD特质之间不存在相关性。在任何组中，毒扁豆碱引起的情绪反应与血浆皮质醇、催乳素或生长激素的变化之间，或与毒扁豆碱输注后的恶心或其他副作用之间均无相关性。这些数据表明，BPD与对毒扁豆碱激发的急性抑郁反应之间存在关联，并且胆碱能系统可能参与了轴II障碍中情感的调节。
