精神分裂病에서의 血清Prolactin, Growth Hormone의 含量 및 Dapanmine-b-Hydroxylase의 辱性에 關한 硏究

Study on Serum Prolactin and Growth Hormone Contents and Dopamine-j8-Hydroxylase Activity in Schizophrenics

Many investigators in biologic research have shown interests in prolactin and growth hormone (GH) which are mainly regulated by dopamine (DA). Dopamine•b.hydroxylase(DBH), which is involved in the conversion of DA to norepinephrine, was introduced to biologic research on the basis of the suggestion that its deficits could result in the hyperdopaminergic state and the noradrenergic deficiency which was thought to be the cause of emotional withdrawal and anhedonia of schizophrenic patients. To investigate the DA mechanism of schizophrenics the changes of prolactin, GH and DBH during neuroleptics treatment, after washout and after pimozide treatment were analysed in comparison with various clinical factors. The responses of prolactin and GH after administration of different doses of apomorphine were also compared with the clinical variables. The results are as follows. 1. After the administration of pimozide the serum levels of prolactin increased significantly without significant changes of GH levels. The changes of activities of DBH showed some peculiar pattern, i.e., at first (3rd week after neuroleptics administration) it increased significantly, and later it decreased to the baseline level. 2. The changes of levels of prolactin and GH after neuroleptics washout and during pimozide treatment showed nearly no relation to clinical variables and changes of symptoms, but those of DBH showed some relation in the case of certain patients who improved slightly after pimozide treatment. 3. Tardive dyskinetic patients showed blunted GH response compared with non-dyskinetic patients after apomorphine administration, and the response was significantly low after 0.5mg of apomorphine administration. 4. Prolactin and GH responses were compared to clinical changes after neuroleptics treatment. A certain group showed presynaptic effects of apomorphine, i.e., the levels of prolactin increased after small dose(0.02mg) of apomorphine administration. This group also has the low activity of DBH. The subgroup which has the presynaptic supersensivity and low activity of DBH showed clinically slight improvement after neuroleptics administration. In conclusion, the apparent absence of difference of prolactin and GH may indicate that the central dopaminergic activity of schizophrenics cannot be simply heralded during neuroleptics treatment and after washout. It is suggested that there exists an alteration of pre-and post-synaptic receptor sensitivity in tardive dyskinesia, and there may be a subgroup that has a different biochemical predisposition and also shows different clinical response after neuroleptics treatment.