Frankle W Gordon, Laruelle Marc
Department of Psychiatry, Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York 10032, USA.
Ann Nucl Med. 2002 Nov;16(7):437-46. doi: 10.1007/BF02988639.
Molecular imaging, the study of receptors, transporters and enzymes, as well as other cellular processes, has grown in recent years to be one of the most active neuroimaging areas. The application of single photon emission tomography (SPECT) and positron emission tomography (PET) techniques to the study of psychiatric illness has lead to increased understanding of disease processes as well as validated, in vivo, theories of illness etiology. Within the field of psychiatry these techniques have been applied most widely to the study of schizophrenia. Studies within schizophrenia are largely limited to either the dopamine or serotonin system. This is due in large part to the availability of suitable radiotracers as well as the current theories on the etiology of the illness. Two basic study designs are used when studying schizophrenia using molecular imaging and make up the majority of studies reviewed in this manuscript. The first type, termed "clinical studies," compares the findings from PET and SPECT studies in those with schizophrenia to normal controls in an attempt to understand the pathophysiology of the illness. The second study design, termed "occupancy studies," uses these techniques to enhance the understanding of the mechanism of action of the medications used in treating this illness. This review will focus on the findings of molecular imaging studies in schizophrenia, focusing, for the most part, on the serotonin and dopamine systems. Emphasis will be placed on how these findings and techniques are currently being used to inform the development of novel treatments for schizophrenia.
分子成像,即对受体、转运体、酶以及其他细胞过程的研究,近年来已发展成为最活跃的神经成像领域之一。单光子发射断层扫描(SPECT)和正电子发射断层扫描(PET)技术在精神疾病研究中的应用,增进了人们对疾病过程的理解,并在体内验证了疾病病因的理论。在精神病学领域,这些技术在精神分裂症研究中的应用最为广泛。精神分裂症的研究主要局限于多巴胺或血清素系统。这在很大程度上归因于合适的放射性示踪剂的可用性以及当前关于该疾病病因的理论。在使用分子成像研究精神分裂症时,采用了两种基本的研究设计,它们构成了本手稿中所综述的大部分研究。第一种类型称为“临床研究”,将精神分裂症患者的PET和SPECT研究结果与正常对照进行比较,以试图了解该疾病的病理生理学。第二种研究设计称为“占有率研究”,使用这些技术来加深对用于治疗该疾病的药物作用机制的理解。本综述将重点关注精神分裂症分子成像研究的结果,大部分聚焦于血清素和多巴胺系统。重点将放在这些发现和技术目前如何被用于为精神分裂症新疗法的开发提供信息。