用部分多巴胺激动剂治疗的临床反应与奖励处理的变化有关
Karen Tangmose1, Egill Rostrup2, Kirsten Borup Bojesen1
1Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark.
阿里皮普拉治疗使精神病患者的奖励处理正常化,特别是在那些对药物有反应的人群中. 尾状核中的这种正常化表明治疗响应者中存在多巴胺作用机制.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 奖励处理的异常神经编码与精神病有关.
- 部分多巴胺激动剂治疗对精神病中奖励处理的影响仍然不清楚.
- 不同治疗对响应者与非响应者的奖励处理的影响尚不清楚.
研究的目的:
- 为了研究阿里皮普拉单一治疗对抗精神病前的精神病患者的奖励处理的影响.
- 检查治疗反应是否影响奖励处理中的变化.
- 探索潜在的多巴胺和非多巴胺作用机制是治疗效果的基础.
主要方法:
- 功能性磁共振成像 (fMRI) 用于33名精神病患者和33名对照患者在阿里皮普拉单疗6周前后进行.
- 一个货币激励延迟任务评估的动机突出处理和负结果评估 (NOE).
- 根据≥30%的积极症状减少,患者被归类为响应者.
主要成果:
- 在基线,精神病患者与对照人群相比,在尾部和背侧前额皮质中显示出NOE信号的增加.
- 阿里皮普拉治疗使尾状NOE信号正常化,主要是由响应者驱动的.
- 响应者在尾状体中表现出更好的动机突出信号,这表明了多巴胺作用机制.
结论:
- 阿里皮普拉单疗可以使精神病中的异常奖励处理正常化,特别是在响应者中.
- 尾状核的动机突出性和NOE信号可能由响应者中的多巴胺基机制调节.
- 非多巴胺作用机制可能是非响应者的背侧前额叶皮质中异常NOE处理的基础.
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