帕利哌酮和利培酮对精神分裂症患者脑源性神经营养因子与事件相关电位N400的影响

Effects of paliperidone and risperidone treatment on brain-derived neurotrophic factor and event-related potential N400 in schizophrenia patients

目的比较帕利哌酮和利培酮对首发精神分裂症患者脑源性神经营养因子(BDNF)与事件相关脑电位N400的影响。方法首发精神分裂症患者90例,随机分为帕利哌酮组和利培酮组各45例,给予帕利哌酮(6~12 mg·d^(-1))和利培酮(3~6 mg·d^(-1))治疗12周,比较两组患者治疗前、后血清BDNF水平、事件相关脑电位N400潜伏期及波幅,并分析其与阳性与阴性症状量表(PANSS)分之间的关系。结果两组各有3例因不能耐受不良反应而脱落。两组患者治疗后血清BDNF水平均有回升,差异有显著意义(P<0.01),但组间比较无显著差异(P>0.05)。治疗后,两组患者匹配条件下的N400潜伏期缩短、波幅回升(P<0.01);非匹配条件下帕利哌酮组N400潜伏期缩短(P<0.05),而利培酮组N400波幅增高(P<0.01)。两组患者治疗后PANSS总分均明显下降(P<0.01),但组间比较无显著差异(P>0.05)。相关分析显示,帕利哌酮组PANSS减分率与血清BDNF升高值存在正相关(r=0.417,P<0.05),利培酮组未发现两者间存在相关(r=0.103,P=0.516)。结论帕利哌酮及利培酮均可提升精神分裂症患者血清BDNF水平,改善患者认知功能(N400潜伏期与波幅)。

AIM To compare the effects of paliperidone and risperidone on brain-derived neurotrophic factor（BDNF） and event-related brain potential N400 in patients with first-episode schizophrenia.METHODS Totally 90 patients with first-episode schizophrenia were randomly divid ed into the paliperidone group and the risperidone group,treated with paliperidone（6-12 mg·d^-1） and risperidone（3-6 mg·d^-1） respectively for 12 weeks.Serum BDNF concentrations and event-related potential N400 latency and amplitude were compared between the two groups before and after the treatment,and the relationship between them and scores of Positive and Negative Symptoms Scale（PANSS） were calculated.RESULTS There were 3 patients in each group dropped out,due to the irresistance of the adverse drug reactions.After the treatment,the levels of serum BDNF in both groups significantly increased（P〈0.01）,while no significant difference was found between the two groups（P〈0.05）.The N400 latency reduced and N400 amplitude increased in congruent condition in the two groups（P〈0.01）,and under the incongruent conditions,the N400 latency was shortened（P〈0.05） in the paliperidone group and the N400 amplitude of the risperidone group was increased（P〈0.01）.After the treatment,the total scores of PANSS in both groups decreased significantly（P〈0.01）,but the difference between the groups was not significant（P〉0.05）.A positive correlation between the rate of PANSS reduction and the increasing value of serum BDNF after the treatment was found in the paliperidone group（r = 0.417,P〈0.05）,but it was not found in the risperidone group（r = 0.103,P = 0.516）.CONCLUSION Both paliperidone and risperidone could increase the serum BDNF concentration in patients with schizophrenia and improve the cognitive function of patients（N400 latency and amplitude）.