精神分裂症幻视的机制研究进展  

Research progress on multiple mechanisms underlying visual hallucinations in schizophrenia patients

作　　者：蒋昱晨 韩琼仪 杜小翠 甄国婷 田晋东 高耀 刘莎[3] 杜鑫哲 JIANG Yuchen;HAN Qiongyi;DU Xiaocui;ZHEN Guoting;TIAN Jindong;GAO Yao;LIU Sha;DU Xinzhe(The First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学,太原030001 [2]山西医科大学基础医学院创新创业学院 [3]山西医科大学第一医院精神卫生科

出　　处：《中国神经精神疾病杂志》2024年第8期508-512,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金青年项目(编号:82301725);山西省自然科学基金(编号:202203021212038,202203021212028);山西省省级大学生创新创业训练项目(编号:20230321);山西省省级大学生创新创业训练项目(编号:20240369);中国博士后科学基金第73批面上资助(编号:2023M732155);山西省高等学校科技创新项目(编号:2022L132)。

摘　　要：幻视(visual hallucination,VH)是精神分裂症患者常见的症状之一,其机制尚未完全阐明。研究发现多巴胺(dopamine,DA)系统功能失调、谷氨酸系统α-氨基-3-羟基-5-甲基-4-异恶唑丙酸(α-amino-3-hydroxy-5-methyl-4-isoxazole-propionate,AMPA)受体过度激活及γ-氨基丁酸(γ-aminobutyric acid,GABA)能神经元功能障碍会诱发精神分裂症患者产生VH。此外,脑结构和功能网络与视觉网络异常也与VH发生密切相关。对精神分裂症患者产生VH的神经化学和神经损伤机制进行综述,可以深入认识VH的疾病特点,在精神分裂症患者的早期诊断、病情评估和制定治疗方案时做出更为准确的判断。Visual hallucination(VH)is a common symptom of schizophrenia,the underlying mechanism has not been fully elucidated.It has been found that the dysfunction of dopamine(DA)system,the overactivation ofα-amino-3-hydroxy-5-methyl-4-isoxazole-propionate(AMPA)receptor in glutamate system and the dysfunction ofγ-aminobutyric acid(GABA)ergic neurons can induce VH in patients with schizophrenia.In addition,abnormalities in brain structural and functional networks and visual networks are also closely related to the occurrence of VH.The purpose of this paper is to review the neurochemistry and nerve injury mechanism of VH in schizophrenic patients to deeply understand the characteristics of VH,and make more accurate judgment in the early diagnosis,condition evaluation and treatment plan of schizophrenic patients.

关 键 词：幻视 精神分裂症 多巴胺能系统 谷氨酸能系统 γ-氨基丁酸能系统 脑网络 灰质体积 海马 

分 类 号：R749.3[医药卫生—神经病学与精神病学]