精神分裂症患者非典型抗精神病药治疗前后的脑功能磁共振的研究进展

综述精神分裂症患者非典型抗精神病药治疗前后脑功能磁共振的研究进展。     

脑影像学对重度抑郁障碍预后预测的研究进展

脑结构、功能磁共振成像作为预测精神疾病疗效和预后的生物学指标正越来越多地在重度抑郁障碍中得到广泛应用。本文主要对近年来结构和功能磁共振成像在重度抑郁障碍治疗前后脑结构、功能的影像学变化以及在预测预后等方面进行综述。     

PET检查难治性分裂症病人中枢D_2受体结合率

本文研究长期住院分裂症病人脑内D_2受体阻断与抗精神病药物疗效的关系,以及与治疗无效者锥体外系症状的关系。方法:试验组,6例病人,男2例,女4例,根据DSM-Ⅲ-R诊断为精神分裂症,排除有器质性病因者。病程至少6年。在正电子发射成像技术(PET)扫描前,病人用中、高剂量的抗精神病药治疗至少6周而无显著疗效。锥外系症状在未使用抗胆碱能药物时用Chouinard评定量表评定,精神病症状用现症检查表(PSE)、精神病简明评定量表(BPRS)评定。对照组为5名健康男     

诱发电位在精神分裂症中的相关应用及研究新进展

脑诱发电位有很多经典成分，在精神分裂症研究中有一些特征。抗精神病药可能会对诱发电位产生影响，但确切机制不清。诱发电位与脑神经影像学联合应用，更有可能清楚知道精神分裂症患者脑结构和功能何处异常以及异常是如何发生的。     

精神病临床高危灰质结构的研究进展

精神分裂症是一种大脑结构和功能异常的严重精神障碍。早期发现及干预处于精神分 裂症前驱期的个体可极大改善其预后。目前,对精神病临床高危（CHR）进行早期识别的客观指标较少。 随着神经影像学技术的发展,许多研究致力于通过大脑结构磁共振成像寻找 CHR 脑灰质生物标志物。 相关研究报道了 CHR 脑皮层及皮层下影像学的异常,但少有一致结论。现就 CHR 结构磁共振成像的研 究进展进行综述,旨在为临床实践及未来研究提供参考。     

精神分裂症患者血脑屏障损伤研究进展

大量研究显示精神分裂症患者存在广泛的脑结构损伤及功能紊乱,另有研究表明,精神分裂症患者可能存在血脑屏障受损,包括神经影像学等一些新的技术已被用于血脑屏障损伤的相关研究中,但应用于精神分裂症中研究的仍较少。我们旨在针对精神分裂症患者血脑屏障损伤的检测方法、损伤机制、免疫学及与抗精神病药影响有关方面的研究进行综述,以进一步理解血脑屏障损伤在精神分裂症发病机制、诊断及治疗方面的作用。     

精神分裂症药物治疗的“物稀为贵”（英文）

概述:在中国和其它亚洲国家中用抗精神病药联合治疗精神分裂症要比在西方国家更为常见,其原因尚不清楚,可能与临床医生的盲目信念有关,即认为用多种药物治疗更可能获得满意的临床疗效。抗精神病药物是治疗精神分裂症患者的主要方法,但抗精神病药物的联用及大剂量使用只会大幅增加风险而不会提高临床疗效。人们普遍认为大剂量使用抗精神病药以及多药联用与药物不良反应的发生率增加、持续时间延长、程度更严重等相关。新近的研究证据还表明,抗精神病药联用及抗精神病药物总剂量相应增高会导致较高的纹状体D2受体占有率(致使药物耐受及停药困难),并使精神分裂症中已受损的突触可塑性恶化(使与此状态相关的认知功能损害"雪上加霜")。临床医生需要在精神分裂症的精神药物治疗中遵循"物稀为贵"的原则。     

磁共振成像以线性、面积、体积、容积评估阿尔茨海默病的结构影像学特点

近年来磁共振成像技术在阿尔茨海默病相关研究中的应用发展迅速。磁共振成像结构影像学主要介绍了磁共振成像线性和面积测量、磁共振成像体积测量和磁共振容积再现三方面,其研究热点主要集中于阿尔茨海默病患者异常脑结构的分布,以及特征性结构内侧颞叶,尤其是海马,杏仁核,以及内嗅皮质在结构在阿尔茨海默病早期诊断治疗中的作用。磁共振成像功能影像学主要包括了功能磁共振成像、扩散加权成像及扩散张量成像等新技术在阿尔茨海默病患者早期脑功能改变中的应用。随着这些研究的进展突破,磁共振成像影像技术将有助于进一步深入了解阿尔茨海默病的发病机制及生物学特征。     

文拉法辛辅助治疗精神分裂症阴性症状Meta分析

目的:探讨文拉法辛治疗精神分裂症阴性症状的疗效和不良反应.方法:用Meta分析方法对8项文拉法辛合并抗精神病药治疗精神分裂症阴性症状研究文章进行再分析.结果:文拉法辛合并抗精神病药治疗精神分裂症阴性症状其治疗前后组内比较效应极强(Z=5.79,P＜0.01),与只用抗精神病药治疗比较差异有显著性(Z=3.02,P＜0.01).结论:文拉法辛合并抗精神病药物治疗精神分裂症阴性症状安全、有效.     

小剂量氯丙嗪治疗精神分裂症42例近期疗效观察

在发掘祖国医学遗产过程中,一些单位往往在用中草药的同时合并小剂量抗精神病药或物理疗法来治疗精神分裂症,藉以观察中草药效果。为了排除小剂量抗精神病药物对所并用的中草药疗效的影响,本文采用最常用的抗精神病药盐酸氯丙嗪日量300mg治疗42例精神分裂症。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.