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首页> 外文期刊>The British journal of psychiatry : >Alterations in cortical and extrastriatal subcortical dopamine function in schizophrenia: Systematic review and meta-analysis of imaging studies
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Alterations in cortical and extrastriatal subcortical dopamine function in schizophrenia: Systematic review and meta-analysis of imaging studies

机译：精神分裂症的皮质和纹状体皮层下多巴胺功能的改变：影像学研究的系统评价和荟萃分析

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Background: The hypothesis that cortical dopaminergic alterations underlie aspects of schizophrenia has been highly influential. Aims: To bring together and evaluate the imaging evidence for dopaminergic alterations in cortical and other extrastriatal regions in schizophrenia. Method: Electronic databases were searched for in vivo molecular studies of extrastriatal dopaminergic function in schizophrenia. Twenty-three studies (278 patients and 265 controls) were identified. Clinicodemographic and imaging variables were extracted and effect sizes determined for the dopaminergic measures. There were sufficient data to permit meta-analyses for the temporal cortex, thalamus and substantia nigra but not for other regions. Results: The meta-analysis of dopamine D 2/D3 receptor availability found summary effect sizes of d = -0.32 (95% CI -0.68 to 0.03) for the thalamus, d = -0.23 (95% CI -0.54 to 0.07) for the temporal cortex and d = 0.04 (95% CI -0.92 to 0.99) for the substantia nigra. Confidence intervals were wide and all included no difference between groups. Evidence for other measures/regions is limited because of the small number of studies and in some instances inconsistent findings, although significant differences were reported for D2/D3 receptors in the cingulate and uncus, for D1 receptors in the prefrontal cortex and for dopamine transporter availability in the thalamus. Conclusions: There is a relative paucity of direct evidence for cortical dopaminergic alterations in schizophrenia, and findings are inconclusive. This is surprising given the wide influence of the hypothesis. Large, well-controlled studies in drug-naive patients are warranted to definitively test this hypothesis.
机译：背景：精神分裂症方面的皮质多巴胺能改变的假说具有很大的影响力。目的：汇集和评估精神分裂症的皮质和其他纹状体区域多巴胺能改变的影像学证据。方法：在电子数据库中搜索精神分裂症患者纹状体多巴胺能功能的体内分子研究。确定了23项研究（278例患者和265例对照）。提取临床指纹和影像学变量，并确定多巴胺能措施的疗效大小。有足够的数据可以对颞叶皮质，丘脑和黑质进行荟萃分析，而其他区域则没有。结果：对多巴胺D 2 / D3受体可用性的荟萃分析发现，丘脑的总效应大小为d = -0.32（95％CI -0.68至0.03），d = -0.23（95％CI -0.54至0.07）。黑质的颞叶皮质和d = 0.04（95％CI -0.92至0.99）。置信区间宽，所有组之间均无差异。由于研究数量少，在某些情况下研究结果不一致，因此其他措施/区域的证据有限，尽管据报道扣带回和un骨中D2 / D3受体，额叶皮层中D1受体和多巴胺转运蛋白的可用性存在显着差异在丘脑。结论：精神分裂症的皮质多巴胺能改变的直接证据相对较少，结果尚无定论。考虑到该假设的广泛影响，这令人惊讶。需对未经药物治疗的患者进行大量，对照良好的研究，以明确检验这一假设。

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