摘要
背景:精神分裂症的病因及病理机制不明,传统的多巴胺(Dopamine,DA)假说不能完全解释其病理学及治疗学。谷氨酸(glutamate,Glu)及γ-氨基丁酸(γ-aminobutyric acid,GABA)假说认为精神分裂症患者脑内的Glu或GABA浓度异常。磁共振波谱(magnetic resonance spectroscopy,MRS)技术发现精神分裂症谷氨酸类物质水平在前额叶腹内侧(ventromedial prefrontal cortex,vmP FC)(包括前扣带回)(anterior cingulate cortex,ACC)升高。目的 :探讨谷氨酸系统(谷氨酸及γ-氨基丁酸)在精神分裂症原因学及病理机制中的作用。方法 :24例未服药精神分裂症患者及24例性别、年龄及教育程度相配的健康志愿者入组,应用西门子MRI 3T采集被试的磁共振波谱(magnetic resonance spectroscopy,MRS)数据,感兴趣区包括左侧前额叶背外侧(left dorsolateral prefrontal cortex,lD LPFC)、前额叶腹内侧(ventromedial prefrontal cortex,vmP FC)及前扣带回(anterior cingulate cortex,ACC),运用LCModel软件分析了感兴趣区的γ-氨基丁酸(γ-aminobutyric acid,GABA)、谷氨酸(glutamate,Glu)、谷氨酰胺(glutamine,Gln)、氮乙酰天冬氨酸(N-acetylaspartate,NAA)及氮乙酰天冬氨酸谷氨酸(N-acetylaspartylglutamate,NAAG)等物质浓度。同时应用阳性与阴性症状量表(positive and negative Syndrome scale,PANSS)及临床总体印象量表(Clinical Global Impression Scale,CGI)评估患者的精神症状和疾病严重程度。结果:精神分裂症组和健康对照组前扣带回的GABA浓度分别为1.90(Q1=1.55,Q3=2.09)及2.16(Q1=1.87,Q3=2.59)、Glu浓度分别为6.07(2.48)及6.54(1.99)、Gln浓度分别为0.36(Q1=0.00,Q3=0.74)及0.29(Q1=0.00,Q3=0.59),GABA浓度的组间差异有统计学意义(Z=-2.95,p=0.003),GABA/(NAA+NAAG)的组间差异有统计学意义(t=-2.72,p=0.012),而Glu及Gln的组间差异均无统计学意义。精神分裂症患者组的年龄与前扣带回的GABA浓度呈负相关(R=-0.494,p=0.014),与GABA/(NAA+NAAG)呈负相关(R=-0.473,p=0.020),但对照组无
Background:The etiology and pathomechanism of schizophrenia are unknown.The traditional dopamine(DA)hypothesis is unable to fully explain its pathology and therapeutics.The glutamate(Glu)andγ-aminobutyric acid(GABA)hypotheses suggest Glu or GABA concentrations are abnormal in the brains of patients with schizophrenia.Magnetic resonance spectroscopy(MRS)show glutamate level increases in the ventromedial prefrontal cortex(vmPFC)including the anterior cingulated cortex(ACC)in those with schizophrenia.Aims:To investigate the function of the glutamate system(glutamate andγ-aminobutyric acid)in the etiology and pathomechanism of schizophrenia.Methods:24drug na?ve patients with schizophrenia and24healthy volunteers were matched by gender,age,and educational level.The Siemens3T MRI system was used to collect the magnetic resonance spectroscopy(MRS)data of the subjects.The regions of interest included the left dorsolateral prefrontal cortex(lDLPFC),ventromedial prefrontal cortex(vmPFC),and anterior cingulate cortex(ACC).LCModel software was used to analyze the concentrations ofγ-aminobutyric acid(GABA),glutamate(Glu),glutamine(Gln),N-acetylaspartate(NAA),and N-acetylaspartylglutamate(NAAG)in the region of interest.Meanwhile,the Positive and Negative Syndrome Scale(PANSS)and the Clinical Global Impression Scale(CGI)were used to assess the mental symptoms and severity of the disease.
作者
陈天意
王颖婵
张建业
汪作为
许嘉乐
李瑶
杨志磊
刘登堂
Tianyi CHEN;Yingchan WANG;Jianye ZHANG;Zuowei WANG;Jiale XU;Yao LI;Zhilei YANG;Dengtang LIU
出处
《上海精神医学》
CSCD
2017年第5期277-286,共10页
Shanghai Archives of Psychiatry
基金
The National Natural Science Foundation of China(project code:81371479)
Shanghai Science and Technology Commission Guidance project(project code:15411964400)
“Joint Key Project Tackling Important Diseases”of Health Department of Shanghai Municipal Government(project code:2014ZYJB0002)
Appropriate Technique of Municipal Hospital in Shanghai
Shanghai Mental Disease Clinical Medical Center(2014)
Department of Early Psychiatric Disorders of Shanghai Mental Health Center(2013-YJTSZK-05)
Project of Shanghai Municipal Health and Family Planning Commission(20144Y0054)
The Shanghai Natural Science Foundation of China(16ZR1430500)
关键词
精神分裂症
磁共振波谱
γ-
氨基丁酸
谷氨酸
schizophrenia
magnetic resonance spectroscopy
γ-aminobutyric acid
glutamate
