Bartlett E J, Brodie J D, Simkowitz P, Schlösser R, Dewey S L, Lindenmayer J P, Rusinek H, Wolkin A, Cancro R, Schiffer W
Department of Psychiatry, New York University Medical Center, NY 10016, USA.
Am J Psychiatry. 1998 Mar;155(3):337-43. doi: 10.1176/ajp.155.3.337.
The CNS metabolic response to a neuroleptic challenge in treatment-responsive and nonresponsive schizophrenic patients was measured in order to examine the relation between treatment outcome and the capacity to alter neurochemical function in response to acute receptor blockade.
Positron emission tomography (PET) and [18F]fluorodeoxyglucose (FDG) were used to measure regional cerebral metabolism in seven schizophrenic patients judged to have been responsive to drug treatment previously and seven nonresponsive schizophrenic patients after a drug-free period of at least 3 weeks (baseline) and again 12 hours after administration of 5.0 mg of haloperidol.
The haloperidol challenge caused widespread decreases in absolute metabolism in the nonresponsive patients but not the responsive patients. These group differences reflect the findings on the second (challenge) scans, since metabolic values at baseline were not statistically different in the two groups. The pattern of decreased metabolic activity in the nonresponders after the haloperidol challenge is similar to that previously observed in normal subjects.
The metabolic response to drug challenge separates treatment responders from nonresponders and normal subjects. The results suggest that subtyping of schizophrenia (and other psychiatric disorders) can be achieved by measuring the physiologic response to a pharmacologic challenge in vivo with chemical brain-imaging techniques.
测量治疗反应性和无反应性精神分裂症患者对神经阻滞剂激发试验的中枢神经系统代谢反应，以研究治疗结果与急性受体阻断后改变神经化学功能能力之间的关系。
使用正电子发射断层扫描（PET）和[18F]氟脱氧葡萄糖（FDG）测量7名先前被判定对药物治疗有反应的精神分裂症患者和7名无反应性精神分裂症患者在至少3周的无药期（基线）以及给予5.0毫克氟哌啶醇12小时后的局部脑代谢。
氟哌啶醇激发试验导致无反应性患者的绝对代谢普遍降低，但反应性患者未出现这种情况。这些组间差异反映了第二次（激发）扫描的结果，因为两组基线时的代谢值无统计学差异。氟哌啶醇激发试验后无反应者代谢活性降低的模式与先前在正常受试者中观察到的相似。
对药物激发试验的代谢反应可区分治疗反应者与无反应者及正常受试者。结果表明，通过用化学脑成像技术在体内测量对药物激发试验的生理反应，可以实现精神分裂症（及其他精神障碍）的亚型分类。
