肝豆状核变性的血清和脑脊液递质的初步报告

本文应用萤光分光光度计测定44例肝豆状核变性患者血清及脑脊液的单胺类递质前体物一色氨酸和酪氨酸以及5—HT、5—HIAA、NE 和 DA 等。从42例的 CSF 值分析 DA、NE、5—HIAA 等浓度与正常人无显著差异。血清色氨酸较对照组增高,其增高原因尚待进一步探讨。     

儿童精神分裂症患者脑脊液中氨基酸神经递质的测定

目的　探讨儿童精神分裂症可能的发病机制。方法　采用反向高效液相色谱法 ,测定16例儿童精神分裂症患儿 (患儿组 )和 11例患阑尾炎的患儿 (对照组 )脑脊液 (CSF)中谷氨酸、天门冬氨酸 (兴奋性氨基酸 )和甘氨酸 (抑制性氨基酸 )的浓度并进行比较。结果　患儿组CSF中谷氨酸为(9 7± 3 1) μmol L ,甘氨酸为 (9 1± 3 7) μmol L ,低于对照组 [分别为 (41 9± 2 2 3) μmol L和 (16 1±11 8) μmol L],而天门冬氨酸含量两组差异无显著性。 结论　儿童精神分裂症的发病机制中可能有氨基酸神经递质的参与。     

精神分裂症患者脑脊液TNF检测

目的：了解肿瘤坏死因子（ＴＮＦ）在精神分裂症免疫机理中的作用。方法：在建立脑脊液细胞微量培养技术的基础上,应用放射免疫分析法,检测了３６例精神分裂症患者脑脊液上清中ＴＮＦ含量。结果：患者脑脊液ＴＮＦ含量较对照组明显增高。脑脊液细胞在ＰＨＡ刺激下产生ＴＮＦ的功能亦明显增强。结论：ＴＮＦ介导的免疫功能异常可能参与了精神分裂症的发病过程。     

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-HT)及其代谢产物5-羟吲哚醋酸(5-HIAA)和其前体物质色氨酸(TRP)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HPLC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-HIAA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-HT代谢障碍的假说，认为5-HT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。     

癫痫患者脑脊液生长抑素测定

本文对25例正常人37例癫痫（EP）患者脑脊液做生长抑素（SOM）测定，发现正常人≤20岁与＞20岁SOM差别有显著意义，即年龄越大，脑脊液中（CSF）SOM值越低。在癫痫组，年龄＞20岁CSF中SOM水平显著高于对照组（P＜0．01）。发作形式对CSF-SOM无影响。发病年限≤10年，SOM值明显高于对照组（P＜0．05），发病＞10年的，SOM值与对照组无差异。同时发现长期用抗癫痫药者，CSF-SOM值与对照组无差异，未用药者明显高于对照组（P＜0．001）。CSF1-SOM的变化与CT，MRI的改变及SPECT所示放射性同位素吸收稀疏区相关。     

精神分裂症患者脑脊液中神经元特异性烯醇化酶和髓鞘碱性蛋白的研究

目的 探讨精神分裂症患者是否有脑损伤。方法 对33例精神分裂症患者和9例对照组手术病人的脑脊液（CSF）中神经元特异性烯醇化酶（NSE）和髓鞘碱性蛋白（MBP）采用双抗体夹心酶联法测定。结果 病例组的NSE的含量与对照组比较有显著性差异（P<0.01）。病例组脑脊液中NSE和MBP的含量呈正相关。结论　提示精神分裂症患者有脑损伤。     

精神分裂症异质性及其中枢五羟色胺功能研究

本文应用高效液相色谱(HPLC)对67例精神分裂症及10例健康对照组脑脊液中色氨酸(TRP)、五羟色胺(5-HT)、五羟吲哚乙酸(5-HIAA)进行测试,同时引入5-HT相对代谢率概念用5-HIAA/5-HT表示,并以Andreasen分型标准划分42例阳性精神分裂症和25例阴性精神分裂症。结果发现,精神分裂症患者脑脊液中TRP明显低于正常对照组,阳性(Ⅰ型)分裂症5-HIAA以及5-HIAA/5-HT明显低于阴性(Ⅱ型)精神分裂症,并对精神分裂症的5-HT代谢障碍假说及其异质性进行了讨论。     

脑型肌酸激酶同功酶在脑血管病中的意义 Ⅱ.急性脑血管病患者血清和脑脊液中CKBB变化及与CT片上病损大小的关系

用改良的ELISA检测25例正常对照组和32例急性脑血管病患者的血清和脑脊液(CSF)中的脑型肌酸激酶同功酶BB(creatine kinase isoenzyme BB)浓度。32例急性脑血管病患者CSF CKBB平均水平为16.62±8.3ng/ml,明显高于对照组(7.5—4.8ng/ml)。发病24h内CSFCKBB轻微增高,24～48h达高峰,以后下降,7天左右尚未恢复正常。病初CSF CKBB水平明显高于恢复期。9例高血压性脑出血的血肿出血量(按CT片上血肿大小计算)与患者CSF CKBB有密切关系(r=0.8127,P<0.01)。血肿体积(X)与CSF CKBB浓度(y)的回归方程y—7.945±0.872X。     

CSF中5-HIAA浓度预示分裂症自杀行为

脑脊液(CSF)中低浓度的5-羟色胺代谢产物5-羟基吲哚乙酸(5-HIAA)与抑郁症的自杀行为有关。但CSF中的5-HIAA与精神分裂症自杀行为的关系尚无确定结果,也没有长期随访。为此,作者进行了一项前瞻性研究。 1979年～1983年间,作者收集了35例未用药精神分裂症(Feighner标准)患者的CSF标本。经6mol/L盐酸酸化后,CSF标本被贮于-40℃待测定。CSF中的5-HIAA浓度用高压液相色谱法(HPLC)测定。35例患者中,在CSF取样的2年内,有2例失访,1例因自然原因死亡,另2例CSF的HPLC检     

首发精神分裂症脑脊液和血清细胞因子水平及其与临床特征的关系

目的检测首发精神分裂症患者脑脊液和血清细胞因子水平,探讨其与临床特征的关系。方法纳入42例首发未用药的精神分裂症患者,采用放射免疫法测定患者脑脊液和血清白细胞介素2(IL-2)、白细胞介素6(IL-6)和肿瘤坏死因子-α(TNF-α)的浓度,采用阳性和阴性症状量表(PANSS)评定其精神症状,脑脊液对照组为10例外科手术患者,血清对照组为试剂盒提供正常的健康者血清细胞因子浓度。结果患者组脑脊液和血清IL-2和TNF-α水平均显著低于对照组(P<0.05),脑脊液IL-6水平高于对照组(P<0.05),血清IL-6与对照组的差异无统计学意义(P>0.05)。患者组脑脊液和血清IL-2、IL-6和TNF-α水平与年龄、体重、病程、PANSS总分及其分量表分等的相关均无统计学意义(P>0.05),而血清TNF-α水平与发病年龄呈正相关(r=0.37,P<0.05)。结论首发精神分裂症患者中枢和外周均存在细胞免疫障碍,但未发现其与临床症状相关,血清TNF-α水平与精神分裂症早期发病可能密切相关。     

老年精神分裂症脑脊液中tau蛋白与认知功能

目的：探讨脑脊液中ｔａｕ蛋白与认知功能缺损之间的关系。方法：精神分裂症组３７例，其他神经系统疾病组２６例，Ａｌｚｈｅｉｍｅｒ病组４５例，对精神分裂症患者评定阳性阴性症状量表，Ｆｕｌｄ物体记忆测验，言辞流畅测验，积木测验及数字广度测验。采用酶联免疫吸附分析检测３组患者中ｔａｕ蛋白浓度。     

Increased cerebrospinal fluid interleukin-6 levels in patients with schizophrenia and those with major depressive disorder

Elevated peripheral levels of interleukin-6 (IL-6) are common findings in schizophrenia and depression. However, previous studies that measured cerebrospinal fluid (CSF) IL-6 levels in these disorders reported controversial results. The present study examined whether CSF IL-6 levels are altered in patients with schizophrenia and those with depression. Lumbar punctures were performed in 32 patients with schizophrenia, 30 with major depressive disorder (MDD), and 35 healthy controls. Serum samples were simultaneously collected from all subjects in the patient groups and from 32 of the control group. CSF and serum IL-6 levels were determined by enzyme-linked immunosorbent assay. Both the patients with schizophrenia and MDD had significantly higher CSF IL-6 levels compared to the controls (schizophrenia: P = 0.0027; MDD: P = 0.012). IL-6 levels were significantly higher in the CSF than in the serum. No significant correlation was observed between CSF and serum IL-6 levels. The present findings suggest that IL-6 of central origin is associated with the pathophysiology of schizophrenia and MDD, although confounding effect of smoking status can not be entirely excluded.     

Associations between childhood living circumstances and schizophrenia: a population-based cohort study.

OBJECTIVE: It has been suggested that household crowding may constitute an environmental risk factor for schizophrenia. The present population-based cohort study explores the associations of childhood family size and living conditions to schizophrenia. METHOD: The cohort comprised people born at Helsinki University Central Hospital from 1924 to 1933, who went to school in the city and were still living in Finland in 1971. Prospectively gathered data from birth and school health records of these 7086 individuals were collected and linked to the Finnish Hospital Discharge Register. RESULTS: Ninety-eight cases of schizophrenia were identified in the cohort. Number of siblings at school start was significantly associated with schizophrenia when adjusted for sex and age of mother. Number of siblings was negatively correlated with body mass index at age 7. Childhood household crowding, defined as number of people per room, and total number of rooms in household were not significantly associated with schizophrenia. CONCLUSION: Our study indicates that the total number siblings in household during childhood is of greater importance than childhood number of inhabitants per room. Subjects who originated from families with many children had been leaner, which may imply that childhood nutritional factors partly is the mediating factor between number of siblings and schizophrenia. Other possible underlying mechanisms of the associations found include infectious and psychological factors.     

Association of schizophrenia with low maternal body mass index, small size at birth, and thinness during childhood

BACKGROUND: Nutritional factors in early life may contribute to the neurodevelopmental deficit in schizophrenia. This study explores the influence of maternal body size, size at birth, and childhood growth on future risk for schizophrenia. SUBJECTS AND METHODS: This population-based cohort study comprised births at Helsinki University Central Hospital in Helsinki, Finland, from 1924 to 1933. Prospective data from birth and school health records of 7086 individuals were collected and linked to the Finnish Hospital Discharge Register. RESULTS: Schizophrenia or schizoaffective disorder had been diagnosed in 114 individuals. A lower late-pregnancy maternal body mass index (BMI) increased the risk (odds ratio [OR], 1.09 per kilogram/meter(2); 95% confidence interval [CI], 1.02-1.17) for schizophrenia among the offspring. The risk of schizophrenia increased with low birth weight (OR, 1.48 per kilogram; 95% CI, 1.03-2.13), shortness at birth (OR, 1.12 per centimeter; 95% CI, 1.03-1.22), and low placental weight (OR, 1.22 per 100 g; 95% CI, 1.04-1.43). Schizophrenia cases were thinner than comparison subjects from 7 to 15 years of age. In a joint model comprising late-pregnancy maternal BMI, body size at birth, and childhood BMI, childhood BMI was an independent predictor of schizophrenia, whereas other factors exhibited attenuated effects. CONCLUSION: Indicators of intrauterine and childhood undernutrition are associated with an increased lifetime risk of schizophrenia.     

Association between excessive frontal cerebrospinal fluid and illness duration in males but not in females with schizophrenia.

OBJECTIVE: Excessive cortical cerebrospinal fluid (CSF) has been acknowledged as a possible marker of a gray matter loss. This excess in schizophrenia is found predominantly in the prefrontal and temporal regions. We hypothesized that the poorer global outcome and treatment response in males with schizophrenia are related to a greater cortical volume loss as compared to females. SUBJECTS AND METHODS: In order to test this hypothesis we have used magnetic resonance imaging (MRI) to study the cortical (prefrontal, temporal, and hemispheric) CSF values in a group of 85 patients with schizophrenia, of whom 56 were males and 29, females. We calculated the residual values of CSF in the patients based on the data pertaining to 45 control subjects and linear regression, from which the normal effects of age and intracranial volume were discounted. These residual scores constitute a quantitative measurement of the excess of CSF due to the disease. RESULTS: Males, but not females, presented a trend-level significant excess of left prefrontal CSF. The prefrontal and temporal residual values were significantly associated with illness duration in males, but not in females. DISCUSSION: These results conform to the worse outcome and the higher severity of structural abnormalities generally found in schizophrenia in male subjects. CONCLUSION: Our data support the hypothesis of accelerated prefrontal cortical loss in males, but not in females with schizophrenia.     

Associations of anxiety-related symptoms with reported history of childhood sexual abuse in schizophrenia spectrum disorders

OBJECTIVE: Research suggests that persons with schizophrenia tend to experience significant levels of anxiety and that history of childhood sexual abuse may predispose some with schizophrenia to experience significant levels of persistent anxiety. It is unclear whether childhood sexual abuse is more closely linked to specific forms of anxiety including symptoms of post-traumatic stress disorder (PTSD). METHOD: Data were gathered from April 2004 through November 2004 on trauma history, PTSD symptoms, social anxiety, and state and trait anxiety from 45 men with a SCID-I-confirmed diagnosis of schizophrenia or schizoaffective disorder and 11 with a SCID-I-confirmed diagnosis of PTSD with no history of psychosis. Participants with schizophrenia spectrum disorders (schizophrenia group) were divided into those with and without history of childhood sexual abuse. Five participants in the schizophrenia group with a history of adult but not childhood sexual assault were excluded from analyses. RESULTS: Analysis of variance comparing the childhood sexual abuse (N = 21) and non-abused (N = 19) schizophrenia groups and the PTSD group on all anxiety assessments revealed that the sexually abused schizophrenia group had significantly higher levels of dissociation, intrusive experiences, and state and trait anxiety than the non-abused schizophrenia group. The schizophrenia groups did not differ statistically on levels of anxious arousal, defensive avoidance, or social anxiety. When compared with participants with PTSD and no psychosis, the sexually abused schizophrenia group had significantly lower levels of state anxiety, anxious arousal, intrusive experiences, and fearful social avoidance but failed to differ statistically on other scores. CONCLUSION: These results, if replicated, could lead to identification of those at risk for anxiety and PTSD and to targeted interventions.     

Neopterin and macrophage inflammatory protein-1alpha in the cerebrospinal fluid of schizophrenic patients: no evidence of intrathecal inflammation

BACKGROUND: Numerous reports support the idea that inflammatory and/or immunological processes contribute to the etiopathogenesis of schizophrenia. Most of the data are, however, based on findings from body compartments outside the central nervous system (CNS). We measured the concentrations of the inflammatory marker neopterin and the chemokine macrophage inflammatory protein-alpha (MIP-1alpha) in the cerebrospinal fluid (CSF) of acutely psychotic schizophrenic patients and of healthy controls. METHODS: The concentration of neopterin was measured in the CSF of 11 schizophrenic patients by radioimmunoassay, and of MIP-1alpha in the CSF from 8 patients using ELISA. Control CSF was collected from 10 and 8 healthy individuals. RESULTS: No statistically significant differences in CSF neopterin or MIP-1alpha were detected between patients and controls or between the patient samples obtained on hospital admission and after the treatment period associated with clinical improvement. CONCLUSIONS: These findings argue against the hypothesis that active inflammatory processes are part of the pathophysiology of acute psychotic episodes in schizophrenia. The possible mechanisms explaining the previously reported aberrations of mononuclear cells and cytokines in schizophrenia are discussed.     

精神分裂症患者脑脊液中氨基酸的测定

为了探索精神分裂症患者脑脊液中氨基酸的变化，应用高效液相色谱法（ＨＰＬＣ）对符合ＣＣＭＤ—２精神分裂症诊断标准的４７例患者及２０例阑尾手术患者的脑脊液中１４种氨基酸进行了测定。结果发现，精神分裂症患者脑脊液中甘氨酸、苯丙氨酸、亮氨酸和丙氨酸的浓度显著高于正常人（Ｐ＜０．００２～０．０５），提示精神分裂症患者脑脊液中氨基酸浓度的变化数据，可能作为该病临床诊断的一项参考指标。