摘要
锂是长期预防双相障碍(BD)的抑郁和躁狂发作的的首选药物。实验和临床研究表明锂对脑功能的神经保护或神经毒性作用,反映锂影响不同脑结构的的倾向。在大多数实验研究中,治疗剂量的锂对各种认知功能产生有利的影响。BD患者在轻度的情绪状态时出现认知的问题,在躁狂或抑郁发作时加重,有时情感正常期还持续存在。对锂治疗BD患者与没有这种药物治疗的患者进行比较的元分析里,显示出药物对认知有中度的负面作用,在临床医生看来,认知功能的负面影响是药物的副作用之一。某些研究中,锂对BD患者认知功能的的影响被证明与药物防治情绪发作的功效相关。对锂的治疗反应良好的患者,在锂治疗的过程中没有情感的复发,认知功能的测试类似于年龄相仿的健康对照组。某些研究还发现锂降低了BD受试者患痴呆症的风险。减轻锂对BD认知的负面影响的机制可能与情感复发的预防、神经可塑性的提高、抗病毒感染和使用适当的药物剂量有关。
关键词: 双相型、认知功能、痴呆症、锂、神经保护、神经毒性。
Current Alzheimer Research
Title:Effect of Lithium on Neurocognitive Functioning
Volume: 13 Issue: 8
Author(s): Janusz K. Rybakowski
Affiliation:
关键词: 双相型、认知功能、痴呆症、锂、神经保护、神经毒性。
摘要: Lithium is the first choice drug for the long-term prophylaxis of depressive and manic episodes in bipolar disorder (BD). Both experimental and clinical studies show either neuroprotective or neurotoxic effects of lithium on brain function, reflecting the propensity of lithium to affect different brain structures. In most experimental studies, lithium, in therapeutic doses, exerts a favourable influence on various cognitive functions. Patients with BD present cognitive problems of mild intensity across mood states, worsening during manic or depressive episodes and, sometimes, also persisting during euthymia. Meta-analyses, comparing bipolar patients treated with lithium with those without the drug show a moderate negative effect of this drug on cognition and, among clinicians, negative impact on cognitive functioning is considered one of the side effect of the drug. In some studies, the effect of lithium on cognitive function in BD was shown to be associated with a prophylactic efficacy of the drug against an occurrence of affective episodes. Excellent lithium responders, having no affective recurrences during lithium therapy, perform on cognitive functions tests similar to those of age-matched, healthy control subjects. Some studies also found a reduction by lithium the risk of dementia in BD subjects. Possible mechanisms alleviating negative impact of lithium on cognition in BD can be connected with the prevention of affective recurrences, improvement of neural plasticity, antiviral action against herpes infection and using the drug in appropriate doses.
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Cite this article as:
Janusz K. Rybakowski , Effect of Lithium on Neurocognitive Functioning, Current Alzheimer Research 2016; 13 (8) . https://dx.doi.org/10.2174/1567205013666160415154701
DOI https://dx.doi.org/10.2174/1567205013666160415154701 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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