精神病中脑功能的谷氨酸调节:神经成像研究的系统审查
Ioana Varvari1, Lara Bolte2, Chiara Colli3
1Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK.
概括
谷氨酸调节剂在精神病中表现出大脑效应,但并不能持续改善症状. 需要更多的研究来将这些大脑变化与精神分裂症患者的持久临床益处联系起来.
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:
- 精神分裂症涉及异常的多巴胺和谷氨酸信号传递.
- 目前的治疗方法向多巴胺,对认知/负面症状的影响有限.
- 谷氨酸调节剂可以解决这些持续的症状.
研究的目的:
- 系统地审查在精神病中使用谷氨酸调节剂的功能神经成像研究.
- 确定这些药物是否会改变大脑活动,化学或连接性.
- 评估大脑变化是否与临床结果相关.
主要方法:
- 按照PRISMA指南进行系统审查.
- 搜索了Medline,Embase,PsycINFO (创立至 2024 年 6 月).
- 包括使用功能神经成像 (1H-MRS,fMRI,EEG等) 的研究. 在精神病患者中使用谷氨酸调节剂 (27篇文章,841名参与者).
主要成果:
- 1H-MRS研究表明,萨科辛,N-乙半氨酸和瑞卢可降低额头/海马谷氨酸.
- fMRI研究表明,NMDAR调节器可以使功能失联正常化,但效果往往是短暂的.
- 脑电图研究表明不匹配负面和马振荡的正常化,与不一致的临床结果相关性.
结论:
- 谷氨酸调节剂显然影响大脑化学和电生理学.
- 这些神经生物学变化与持续的临床益处之间的联系尚不清楚.
- 未来的研究需要更大,更长的多式成像研究,以澄清机制并确定患者子组.
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