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纹状体多巴胺转运体可用性对成人注意力缺陷多动障碍患者哌甲酯反应的影响。

Influence of striatal dopamine transporter availability on the response to methylphenidate in adult patients with ADHD.

作者信息

Krause Johanna, la Fougere Christian, Krause Klaus-Henning, Ackenheil Manfred, Dresel Stefan H

机构信息

Outpatient Clinic for Psychiatry and Psychotherapy, Schillerstr. 11a, 85521, Ottobrunn, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2005 Dec;255(6):428-31. doi: 10.1007/s00406-005-0602-x. Epub 2005 Aug 17.

Abstract

In this study, we investigated whether availability of striatal dopamine transporter (DAT) may have an influence on the response of adult patients with attention deficit hyperactivity disorder (ADHD) on methylphenidate (MPH). In 18 non-smoking and non-medicated adult patients with ADHD, availability of DAT was measured with [(99m)Tc] TRODAT-1 SPECT. Then, the patients received methylphenidate (MPH), individually titrated up to 60 mg per day. Ten weeks later, clinical improvement was rated by Clinical Global Impressions scale. In all, 6 patients were classified as non-responders, and 12 responded to MPH. From the non-responders, 5 presented with a DAT availability below that of normal controls of the same age, whereas in the group of responders all patients had elevated DAT availability. There was a significant negative correlation between values for global clinical improvement and striatal DAT availability. In conclusion, ADHD patients with low DAT availability seem not to respond to therapy with MPH.

摘要

在本研究中,我们调查了纹状体多巴胺转运体(DAT)的可用性是否可能影响成年注意力缺陷多动障碍(ADHD)患者对哌甲酯(MPH)的反应。在18名不吸烟且未接受药物治疗的成年ADHD患者中,用[(99m)Tc]TRODAT - 1单光子发射计算机断层扫描(SPECT)测量DAT的可用性。然后,患者接受哌甲酯(MPH)治疗,剂量个体化滴定至每日60毫克。十周后,用临床总体印象量表评估临床改善情况。总共6名患者被归类为无反应者,12名对MPH有反应。在无反应者中,5名患者的DAT可用性低于同年龄正常对照,而在有反应者组中,所有患者的DAT可用性均升高。总体临床改善值与纹状体DAT可用性之间存在显著负相关。总之,DAT可用性低的ADHD患者似乎对MPH治疗无反应。

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