认知控制相关的mPFC功能的恶化是早期精神病中治疗抵抗的基础
Charlotte M Crisp1, Angad Sahni2, Sze W Pang2
1School of Psychological Sciences, University of Bristol, 12a Priory Road, Bristol, BS8 1TU, UK. ch1640@bristol.ac.uk.
Scientific reports
|June 5, 2024
概括
认知控制缺陷,特别是中间前额叶皮层功能,可能预测早期精神病的抗精神病药物治疗耐药性. 大脑这个区域的恶化.
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.
- 认知科学 认知科学
背景情况:
- 三分之一的精神病患者会产生抗精神病药物治疗的耐药性.
- 治疗耐药性背后的机制在很大程度上是未知的.
- 认知控制功能是治疗耐药性的潜在因素.
研究的目的:
- 调查改变的认知控制功能是否有助于早期精神病中抗精神病药物治疗耐药性.
- 为了检查认知控制,大脑活动和治疗耐药与治疗响应的个体中的谷氨酸水平之间的关系.
主要方法:
- 在基线和1年随访期间研究了50名早期精神病患者 (平均疾病持续时间<2年).
- 在功能性MRI (fMRI) 和MR光谱学中利用了情绪束的奖励学习任务.
- 测量了前皮质 (ACC) 中的谷氨酸水平,并评估了与认知控制相关的大脑活动.
主要成果:
- 治疗耐药的个体表现出右桃体和左桃体的基本活动减弱,随着时间的推移正常化.
- 耐治疗的参与者随着时间的推移,表现出中间前额叶皮层 (mPFC) 活动的下降.
- 在治疗反应良好的个体中观察到mPFC活性和谷氨酸之间的负面关系,但在治疗耐药的个体中没有.
- 右桃体和左桃体的基线活动减少预测了具有高灵敏度和特异性的耐治疗性.
结论:
- 随着时间的推移,mPFC功能的恶化是早期精神病中抗精神病药物治疗耐药性的发展的一个关键因素.
- 这种mPFC功能障碍可能代表无法弥补最初的社会情感网络功能障碍.
- 谷氨酸和mPFC功能之间的脱需要进一步调查,作为潜在的治疗点.
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