精神疾病中的自主功能障碍,与抗精神病药物干预的相互作用和治疗耐药性:全面的系统性审查和元分析
Federica Iannotta1, Felice Iasevoli1, Claudio Caiazza1
1Unit for Treatment-Resistant Psychoses, Section of Psychiatry, Department of Neuroscience, Reproductive Sciences and Dentistry - University of Naples "Federico II", Naples, Italy.
Journal of psychiatric research
|December 31, 2025
概括
自主神经系统 (ANS) 功能障碍,特别是心率变化降低 (HRV),是精神病的核心特征,独立于抗精神病药物. 这些发现表明精神病障碍中潜在的中央自主网络失调.
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.
- 自主神经系统研究 自主神经系统研究
背景情况:
- 自主神经系统 (ANS) 功能障碍在精神病的病理生理学中越来越被认可.
- 这些ANS变化的确切性质和抗精神病药物的影响仍在争论中.
研究的目的:
- 系统地审查和元分析心率变化 (HRV),皮电活动 (EDA) 和精神疾病中的外围生物标志物.
- 澄清ANS功能障碍作为精神病潜在核心特征的作用及其与抗精神病治疗的关系.
主要方法:
- 系统审查和元分析遵循PROSPERO注册的协议 (CRD42024510812).
- 搜索了PubMed和EMBASE数据库,从创立到2024年7月.
- 采用随机效应的元分析,评估异质性,出版偏见和偏见风险.
主要成果:
- 与健康对照组相比,精神病患者的HRV显著降低,特别是副交感指数.
- 这些HRV降低在接受治疗和未接受治疗的患者和与情感障碍进行比较时都被观察到.
- 克洛扎与最明显的HRV降低有关;EDA和其他外围标记物没有显著差异,尽管皮肤导电水平 (SCL) 在抗精神病药物下趋于下降.
结论:
- ANS失调似乎是精神病的一个基本方面,仅部分受到药物的影响,指向中央自主网络功能障碍.
- 神经递质系统的干扰,特别是涉及乙胆,可能起到作用.
- 自主分析可以增强精神病诊断和指导个性化干预,需要进行纵向研究来预测治疗反应.
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