Parsey Ramin V, Hastings Ramin S, Oquendo Maria A, Huang Yung-yu, Simpson Norman, Arcement Julie, Huang Yiyun, Ogden R Todd, Van Heertum Ronald L, Arango Victoria, Mann J John
Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, USA.
Am J Psychiatry. 2006 Jan;163(1):52-8. doi: 10.1176/appi.ajp.163.1.52.
CSF analysis, neuroendocrine challenges, serotonin depletion studies, and treatment studies implicate the serotonergic system in the pathophysiology of major depressive disorder. On the basis of postmortem and imaging studies, the authors hypothesized that subjects with major depressive disorder in a major depressive episode have fewer serotonin transporter sites, compared with healthy subjects.
Serotonin transporter binding potential (f(1)B(max)/K(d)) was determined using positron emission tomography with [(11)C]McN 5652 in six brain regions in 25 medication-free subjects with DSM-IV major depressive disorder during a major depressive episode and in 43 healthy volunteer comparison subjects. All subjects had arterial lines placed to determine metabolite-corrected arterial input functions.
Serotonin transporter binding potential differed significantly by brain region and group. Post hoc analysis revealed lower binding potential in subjects with major depressive disorder, relative to the comparison subjects, in the amygdala and midbrain. The lower binding potential was more pronounced in the depressed subjects who had never received antidepressants. No correlation was found between binding potential in the midbrain and severity of depression or number of days without medication. Binding potential did not differ between suicide attempters and nonattempters.
Subjects in a major depressive episode have lower serotonin transporter binding potential in the amygdala and midbrain, compared to healthy subjects.
脑脊液分析、神经内分泌激发试验、5-羟色胺耗竭研究及治疗研究均表明，5-羟色胺能系统与重度抑郁症的病理生理学有关。基于尸检和影像学研究，作者推测，与健康受试者相比，处于重度抑郁发作期的重度抑郁症患者的5-羟色胺转运体位点较少。
采用正电子发射断层扫描技术，以[(11)C]McN 5652测定25名未服用药物、处于重度抑郁发作期的DSM-IV重度抑郁症患者及43名健康志愿者对照者六个脑区的5-羟色胺转运体结合潜能（f(1)B(max)/K(d)）。所有受试者均留置动脉导管以测定代谢物校正后的动脉输入函数。
5-羟色胺转运体结合潜能在脑区和组别上存在显著差异。事后分析显示，与对照者相比，重度抑郁症患者杏仁核和中脑的结合潜能较低。在从未服用过抗抑郁药的抑郁症患者中，较低的结合潜能更为明显。中脑结合潜能与抑郁严重程度或未服药天数之间未发现相关性。自杀未遂者与未自杀者的结合潜能无差异。
与健康受试者相比，处于重度抑郁发作期的患者杏仁核和中脑的5-羟色胺转运体结合潜能较低。
