한빛사논문
Seoyoung Kim1, Sang Ho Shin1, Barbara Santangelo2, Mattia Veronese2, Seung Kwan Kang3,4, Jae Sung Lee3,4, Gi Jeong Cheon3,5, Woojoo Lee6, Jun Soo Kwon7,8, Oliver D Howes9,10, Euitae Kim11,12,13,*
1Department of Psychiatry, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
2Centre for Neuroimaging Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
3Department of Nuclear Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
4Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, Republic of Korea.
5Institute of Radiation Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
6Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
7Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea.
8Department of Brain & Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.
9Department of Psychosis studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
10Psychiatric Imaging, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital Campus, London, UK.
11Department of Psychiatry, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
12Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea.
13Department of Brain & Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.
*Corresponding author
Abstract
Although antipsychotic drugs are effective for relieving the psychotic symptoms of first-episode psychosis (FEP), psychotic relapse is common during the course of the illness. While some FEPs remain remitted even without medication, antipsychotic discontinuation is regarded as the most common risk factor for the relapse. Considering the actions of antipsychotic drugs on presynaptic and postsynaptic dopamine dysregulation, this study evaluated possible mechanisms underlying relapse after antipsychotic discontinuation. Twenty five FEPs who were clinically stable and 14 matched healthy controls were enrolled. Striatal dopamine activity was assessed as Kicer value using [18F]DOPA PET before and 6 weeks after antipsychotic discontinuation. The D2/3 receptor availability was measured as BPND using [11C]raclopride PET after antipsychotic discontinuation. Healthy controls also underwent PET scans according to the corresponding schedule of the patients. Patients were monitored for psychotic relapse during 12 weeks after antipsychotic discontinuation. 40% of the patients showed psychotic relapse after antipsychotic discontinuation. The change in Kicer value over time significantly differed between relapsed, non-relapsed patients and healthy controls (Week*Group: F = 4.827, df = 2,253.193, p = 0.009). In relapsed patients, a significant correlation was found between baseline striatal Kicer values and time to relapse after antipsychotic discontinuation (R2 = 0.518, p = 0.018). BPND were not significantly different between relapsed, non-relapsed patients and healthy controls (F = 1.402, df = 2,32.000, p = 0.261). These results suggest that dysfunctional dopamine autoregulation might precipitate psychotic relapse after antipsychotic discontinuation in FEP. This finding could be used for developing a strategy for the prevention of psychotic relapse related to antipsychotic discontinuation.
논문정보
TOP52020년 후보
관련 링크
연구자 키워드
연구자 ID
관련분야 연구자보기
소속기관 논문보기
관련분야 논문보기