精神分裂症治疗前后脑脊液5-羟色胺代谢变化的对比研究

目的　观察精神分裂症患者脑脊液５羟色胺（５ Ｈ Ｔ） 及其代谢产物５羟吲哚醋酸（５ Ｈ Ｉ Ａ Ａ） 和其前体物质色 氨酸（ Ｔ Ｒ Ｐ）的功能状态，以及经氯丙嗪治疗后上述物质的代谢变化。方法　应用 Ｈ Ｐ Ｌ Ｃ 法对４０ 例未经治疗的精神分裂症（ 阳性症状为主） 患者与１５ 例非中枢神经系统疾病对照者作上述物质的比较，其中２７ 例精神分裂症患者在接受氯丙嗪治疗８ 周后复查了上述物质。结果　精神分裂症组疗前脑脊液５ Ｈ Ｉ Ａ Ａ 浓度比对照组显著为低，治疗后各物质浓度均显著降低。结论　支持有关精神分裂症５ － Ｈ Ｔ 代谢障碍的假说，认为５ － Ｈ Ｔ 功能低下可能系阳性症状为主精神分裂症的易感标志，该型的症状发生与转归主要与多巴胺的代谢障碍有关。     

以阳性或阴性症状为主的精神分裂症患者的单类神经递质代谢

目的 探讨以阳性症状为主（以下简称阳性）或以阴性症状为主（以下简称阴性）的精神分裂症患者在氯氮平治疗前后脑脊（ＣＳＦ）中高香草酸（ＨＶＡ）和５－羟吲哚乙酸（５－ＨＩＡＡ）浓度的动态变化。方法 对２８例阳性患者和１８例阴性患者进行８周的氯氮平治疗。用高效液相色谱－电化学方法测定患者的ＨＶＡ和５－ＨＩＡＡ浓度。以精神分裂症阳性症状量表（ＳＡＰＳ）和阴性症状表（ＳＡＮＳ）为评定工具。以１２例非中枢神经系     

首发精神分裂症的认知功能与阴,阳性症状和抗精神病药物效应的关系

目的 探讨首发精神分裂症认知功能与阴、阳性症状和抗精神病药物效应的关系。方法 对７８例精神分裂症患者给予氯丙嗪或氯氮平治疗,于治疗前及治疗１２周末各作一次Ｗｉｓｃｏｎｓｉｎ卡片分类测验（ＷＣＳＴ）、韦氏成人智力量表（ＷＡＩＳＲ）、韦氏记忆量表（ＷＭＳ）、语言流利性测验等。另外,４５例正常人也做了上述测验。结果 首发精神分裂症患者存在广泛的认知功能障碍,上述则查结果均较正常对照组差,尤以ＷＣＳＴ明显     

鼠脑反复缺血再灌注海马6种氨基酸、单胺递质及其代谢产物变化的研究

目的：研究脑反复缺血后海马细胞外液氨基酸和单胺递质及其代谢产物的变化规律。方法：采用Ｐｕｌｓｉｎｅｌｌｉ和Ｂｒｉｅｒｌｅｙ４血管闭塞的方法,使鼠脑反复缺血,海马微管透极与高压液相电化学检测,观察细胞外谷氨酸（Ｇｌｕ）,天门冬氨酸（Ａｓｐ）,谷氨酰胺,牛磺酸、丙氨酸,丝氨酸,多巴胺（ＤＡ）,５－羟色胺（５－ＨＴ）及其代谢产物浓度的变化。结果：缺血期,Ｇｌｕ和Ａｓｐ骤然增高５０倍和３０倍。缺血期ＤＡ和５－ＨＴ含量分别增加３０倍和５０倍,随后逐渐下降,再灌注１００ｍｉｎ恢复到基线水平,与此同时,其酸性代谢产物３,４－二羟苯乙酸（ＤＯＰＡＣ）,高香草酸（ＨＶＡ）,５－羟吲哚乙酸（５－ＨＩＡＡ）在缺血期明显下降。结论：缺血期海马细胞外液兴奋性氨基酸和单胺递质急剧大量释放并触发膜离子通道改变。Ｃａ＾＋超载,自由基反应,共同     

Wisconsin卡片分类测验与精神分裂症阴阳性症状

了解精神分裂症阴，阳性症状与Ｗｉｓｃｏｎｓｉｎ卡分分类试验的关系。给１９９４年９－１１月住院的４４例精神分裂症病人进行Ｗｉｓｃｏｎｓｉｎ卡片分类试验及ＳＡＮＳ和ＳＡＰＳ评定，阴性型的ＷＣＳＴ结果明显较差。保存记忆错误数与ＳＡＮＳ评分呈正相关。从ＷＣＳＴ可提示阴性精神分裂症病人有比较明显的额叶功能减退。     

抑郁症患者脑脊液生长抑素及单胺代谢产物浓度与临床症状的关系

目的 探讨抑郁症患者脑脊液生长抑素（ＳＳ）和单胺代谢产物浓度与临床症状的关系,以及神经递质之间的相互作用。方法 应用放射免疫测定方法和高效液相色谱法,测定２３例抑郁症患者脑脊液ＳＳ和５－羟色胺（５－ＨＴ）代谢产物５－羟吲哚之酸（５－ＨＩＡＡ）、去甲肾上腺素（ＮＥ）代谢产物３－甲基－４－羟－苯乙二醇（ＮＨＰＧ）及多巴胺（ＤＡ）代谢产物高香草酸（ＨＶＡ）的浓度。临床症状评估采用汉密尔顿抑郁量表（ＨＡＭ     

神经心理测验预测首发精神分裂症的近期预后

目的：筛选与首发精神分裂症近期预后有关的神经心理测查指标。方法：对１６４例首发精神分裂症患者随机给予氯丙嗪或氯氮平治疗,于治疗前分别作韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击测验、利手测验、动作功能测验、手功能协调测验、连线测验、连线测验Ｂ、威期康辛卡片分类测验（ＷＣＳＴ）及语言流畅性测验等１１项刘经心理测查各１次,并作ＢＰＲＳ、ＳＡＮＳ、功能总体评定量表（ＧＡＦ）各１次,治疗１２周     

内皮素一氧化氮在蛛网膜下腔出血后脑血管痉挛中的动态变化

目的：探讨内皮素（ＥＴ－１）和一氧化氮（ＮＯ）代谢产物在蛛网膜下腔出血（ＳＡＨ）后症状性脑血管痉挛（ＳＣＶＳ）发生机制中的作用。方法：建立兔的症状性脑血管痉挛模型,观察ＳＡＨ后不同时间血浆和脑脊液（ＣＳＦ）中ＥＴ－１和ＮＯ代谢产物含量变化。结果：ＳＡＨ后第４天和第７天血浆和ＣＳＦ中ＥＴ－１含量均显著升高（Ｐ〈０．０１）。且以ＳＡＨ后第４天为著。ＳＡＨ后第４天和第７天血浆和ＣＳＦ中ＮＯ代谢产物含量也明显升高（Ｐ〈０．０１）,但二者之间无显著性差异（Ｐ〉０．０５）。结论：ＳＡＨ后血浆和ＣＳＦ中ＥＴ－１和ＮＯ代谢产物含量增加在ＳＣＶＳ发生机制中起重要作用。     

脑缺血纹状体细胞外液单胺类介质及其代谢物的微透析研究

目的观察脑缺血再灌注时鼠脑纹状体区细胞外液（ＥＣＦ）多巴胺（ＤＡ）、去甲肾上腺素（ＮＥ）、５－羟色胺（５－ＨＴ）及其代谢产物高香草酸（ＨＶＡ）和５－羟吲哚乙酸（５－ＨＩＡＡ）的动态变化。方法采用脑内微透析技术，用高压液相色谱测定了前脑缺血３０ｍｉｎ、再灌注１２０ｍｉｎ时ＥＣＦＤＡ、ＮＥ和５－ＨＴ的变化。结果脑缺血１０ｍｉｎ时ＥＣＦＤＡ、ＮＥ迅速升高为缺血前的２８２和９１４倍，持续整个缺血期，再灌注后迅速下降达缺血前水平。脑缺血期ＨＶＡ、５－ＨＩＡＡ迅速下降，在缺血３０ｍｉｎ时达缺血前的４５％和５２％，再灌注后升高并在再灌注后６０ｍｉｎ，９０ｍｉｎ达缺血前的１５０％、１１３％。结论单胺类介质代谢紊乱参与了缺血性神经元损害     

免疫应答期间脑内多巴胺代谢的变化

应用高效液相色谱－电化学检测法（ＨＰＬＣ－ＥＣＤ）测定大鼠用绵羊红细胞（ＳＲＢＣ）免疫后第２－７天期间，下丘脑，海马和脑干中多巴胺（ＤＡ）及代谢产物高香草酸（ＨＶＡ）的含量，结果表明，下丘脑中ＤＡ含量，在免疫后第３－４天明显升高，第５天明显降低，ＨＶＡ含量在免疫后第２－５天显著地增加，以第４天增加最多，海马中ＤＡ含量在免疫后第５－７天明显减少，而ＨＶＡ含量在此期间显著增加，均以第６天变化最大，脑干     

精神分裂症认知功能损害与病程的关系

目的：探讨精神分裂症认知功能损害的程度与病程关系。方法;分别用韦氏记忆测验,数字划销测验和威斯康星卡片分类测验评估27例急性精神分裂症病人和31例慢性精神分裂症病人的记忆、注意和执行功能。结果：注意损害随病程的延长而加重,记忆和执行功能损害与病程无关。     

Low HVA and normal 5HIAA CSF levels in drug-free schizophrenic patients compared to healthy volunteers: correlations to symptomatology and family history

Cerebrospinal fluid (CSF) levels of homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5HIAA) were determined in 40 drug-free schizophrenic patients and 21 healthy volunteers by a mass fragmentographic method. Twenty-one of the schizophrenic patients were first admissions who had never received neuroleptics. Significantly, lower levels of HVA but not 5HIAA were found in the patient group, and no difference was found between chronic, previously neuroleptic-treated and never-medicated patients. HVA levels correlated positively with social interest and total positive scores on the Nurses Observation Scale for Inpatient Evaluation (NOSIE-30) and negatively with lassitude and slowness of movements on the Comprehensive Psychopathological Rating Scale (CPRS). Low levels of 5HIAA were correlated to the CPRS items delusions and apparent sadness. There were slightly higher CSF levels of 5HIAA in patients with a family history of schizophrenia, but no such difference was seen for HVA. In both schizophrenic and control subjects CSF levels of HVA and 5HIAA showed a strong intraindividual correlation. The results indicate decreased central nervous system dopaminergic turnover in schizophrenia which seems to be associated with "negative" symptomatology.     

精神分裂症症状与认知功能损害的关系

目的：探讨精神分裂症症状与认知功能损害的关系。方法：对１８例阴性精神分裂症和１５例阳性精神分裂症采用氯氮平治疗;对１１例阴性精神分裂症和１３例阳性精神分裂症采用利培酮治疗。并分别评估其治疗前和治疗８周后的阳性症状,阳性症状记忆,注意及执行功能。结果：精神分裂症的记忆损害与阴性症状和阳性症状都呈显著性相关,注意及执行功能损害与阴性症状显著相关,与阳性症状无明显相关;记忆随思维贫乏的改善而改善,注意和执行功能损害的改善与症状的改善无明显相关。结论：精神分裂症认知功能损害主要与阴性症状相关,但精神分裂症的大部分认知功能并不随阴性症状改善而改善。     

强迫症认知功能与临床症状的相关性

目的：探讨强迫症的认知功能与临床症状的相关性。方法：采用韦氏记忆量表（WMS）、数字划销测验、威斯康星卡片分类测验（WCST）评估记忆、注意、执行功能。结果：强迫思维与持续错误呈显著正相关。结论：强迫症的记忆和注意损害障碍与其临床症状严重程度无明显相关,强迫症的持续错误与其强迫思维显著相关。     

Neuropsychological and activity of daily living script performance in patients with positive or negative schizophrenia

Cognitive and psychiatric determinants of impairment of complex activities of daily living (ADLs) were investigated in 33 schizophrenic patients and 16 normal comparison subjects. The schizophrenic patients were cognitively impaired and were deficient in the ADL. However, the impairment of ADL could not be explained specifically by impairment of higher-order executive function or by negative symptoms: memory functions were more related to impairment of ADL and positive symptoms as much as the negative ones. Positive symptoms were significantly related to commissive errors in the ADL, whereas negative symptoms were nonsignificantly related to omissive errors. Negative symptoms were significantly more related to memory impairment than to impairment on measures of higher-order executive function (working memory). This investigation demonstrates that an ecologically oriented approach to test development and measurement of ADL is fruitful in understanding schizophrenia-especially if it is constrained by cognitive constructs compatible with the phenomenology of the disease.     

Effort and cognition in schizophrenia patients

OBJECTIVE: The aim of this study was to determine whether low cognitive test scores in schizophrenia patients are due to insufficient effort and, if so, to what extent. METHOD: Mental effort was measured with the Word Memory Test (WMT), an effort test that has been extensively validated. Schizophrenic patients (n=64), non-psychotic psychiatric patients (n=63), neurological controls (n=20), and normal controls (n=44) were tested with a neuropsychological test battery measuring memory, attention and executive functioning. RESULTS: The majority of the schizophrenia patients and a quarter of the psychiatric patients scored below the cut-offs for normal effort on the WMT. Scores on the effort test explained a significant amount of variance in the neuropsychological test performance of schizophrenic patients. This lends support to the notion that cognitive functioning in schizophrenia is compromised by insufficient effort. Furthermore, poor mental effort was related to negative symptoms. CONCLUSIONS: Poor mental effort might be considered a core symptom of schizophrenia, representing an executive, monitoring or motivational problem. Mental effort should be taken into consideration in the neuropsychological assessment of schizophrenic patients and of psychiatric patients in general. Controlling for this variable may have a considerable impact on research, assessment and treatment of cognitive disorders in schizophrenic patients.     

Comparative effects of risperidone and olanzapine on cognition in elderly patients with schizophrenia or schizoaffective disorder

OBJECTIVE: To examine the effects of risperidone and olanzapine on cognitive functioning in elderly patients with schizophrenia or schizoaffective disorder. METHOD: One hundred seventy-six elderly inpatients and outpatients with schizophrenia or schizoaffective disorder were enrolled in this multicenter, double-blind trial. After their antipsychotic medications were tapered for 1 week, patients were randomly assigned to receive either risperidone 1 to 3 mg/day or olanzapine 5 to 20 mg/day for 8 weeks. Performance on the Continuous Performance Test (CPT), Serial Verbal Learning Test (SVLT), TMT (Trail Making Test) Parts A and B, Wisconsin Card Sorting Test (WCST), and Verbal Fluency Examinations (VFE) was assessed at baseline and at end point. RESULTS: Patients in the risperidone group had improved scores on at least one test of attention, memory, executive function, and verbal fluency, and those in the olanzapine group had improved scores on at least one test of attention and memory function. Scores on the TMT Part B, WCST total errors (executive function domain), and the VFE improved significantly from baseline in the risperidone group but not in the olanzapine group. No significant differences in change scores between the two groups were found. Higher baseline scores on each test predicted more improvement at endpoint. CONCLUSIONS: Low doses of risperidone and olanzapine improve cognitive function in elderly patients with schizophrenia or schizoaffective disorder. Consistent with research in younger populations, these improvements occur in aspects of cognitive functioning related to functional outcome.     

CSF Monoamine Metabolism in Patients with Tardive Dyskinesia: Effect of Oxypertine and Hydroxyzine Pamoate

Abstract: Cerebrospinal fluid (CSF) HVA, MHPG, 5-HIAA, cAMP and cGMP concentrations were measured in schizophrenic patients with tardive dyskinesia before and after a three-week administration of oxypertine (n = 4), hydroxyzine pamoate (n = 4) or placebo (n = 4). The oxypertine administration resulted in a reduction of the CSF HVA concentration and an elevation of the MHPG and cAMP concentrations, associated with a clinical improvement in tardive dyskinesia. The hydroxyzine administration reduced the CSF 5-HIAA concentration in all the patients and the CSF HVA concentration in two of four patients with a clinical improvement. A reduction in the CSF HVA concentration associated with possible therapeutic effects of oxypertine or hydroxyzine may suggest the normalization of a hyperdopaminergic state. Discussions were held that functional disorders of not only the dopaminergic system but the norepinephrinergic and serotoninergic systems may relate to the pathogenesis of tardive dyskinesia.     

Cerebrospinal fluid amine metabolites in acute schizophrenia.

The metabolites of serotonin, dopamine, and norepinephrine, 5-hydroxyindoleacetic acid (5HIAA), homovanillic acid (HVA), and 3-methoxy-4-hydroxy-phenylethylene glycol (MHPG), respectively, were studied in cerebrospinal fluid of patients with acute schizophrenia. Base line levels of these metabolites were not significantly different from those in normal, neurological, and affectively ill controls. Accumulations of 5HIAA and HVA following probenecid administration, which provide a measure of serotonin and dopamine turnover, were also not significantly different in patients with acute schizophrenia and affective illness. After patients had recovered from their acute schizophrenic illness, HVA accumulations were significantly reduced. We discuss results in relation to amine hypotheses of schizophrenia and the suggestion that altered dopamine metabolism may reflect a biological change predisposing to acute schizophrenia.     

认知功能障碍与血清白细胞介素2的关系

目的 :探讨精神分裂症患者认知功能损害与精神症状及血清白细胞介素 2 (IL 2 )水平的关系。　方法 :在 5 7例未服抗精神病药的患者中 ,采用数字划销测验 (CT)、韦氏成人记忆量表 (WMS RC)、威斯康星卡片分类测验 (WCST)测试认知功能 ,用阳性症状与阴性症状量表 (PANSS)评定精神症状 ,同时测定血清IL 2浓度 ,分析其间的关系 ;并将记忆商数 (MQ)≤ 85者与MQ >85者比较血清IL 2水平及精神症状。　结果 :阴性症状分与各项认知测验的成绩均呈显著相关 ,部分认知损害还与一般病理性症状分相关 ,阳性症状分与所有认知测验的成绩均无相关性 ;血清IL 2水平与注意力、记忆力测验成绩呈显著负相关 ,与WCST测验成绩不相关 ;MQ≤ 85者与MQ >85者比较血清IL 2水平及阴性症状显著增高。　结论 :精神分裂症认知损害与阴性症状相关 ,与阳性症状不相关 ;血清IL 2水平可能与精神分裂症的注意力、记忆力损害相联系