Mateos J J, Lomeña F, Parellada E, Font M, Fernández E, Pavia J, Prats A, Bernardo M
Servicio de Medicina Nuclear, Hospital Clínico de Barcelona, Universidad de Barcelona, España.
Rev Esp Med Nucl. 2006 May-Jun;25(3):159-65. doi: 10.1157/13088411.
Extrapyramidal symptoms and Parkinsonism (PS) are side effects commonly observed with antipsychotic treatment. However, about 24% of never-treated schizophrenic patients may suffer from PS, which contrast with that 1% observed from the general population. 123I-FP-CIT SPECT has probe useful to differentiate degenerative from non-degenerative PS, so it could be interesting using it for establishing the functional state of presynaptic dopamine neurons of these patients.
To determine the dopamine transporter binding (DAT) in a homogeneous group of first-episode schizophrenic patients.
An open, transversal study. Thirty schizophrenic in-patients and 15 healthy subjects were recruited. Patients were treated with similar doses of risperidone and all subjects were scanned with 123I-FP-CIT. Extrapyramidal symptoms and psychopathological status was assessed by Simpson-Angus, CGI and PANSS. Semi-quantitative analyses of SPECT images were performed using ROIs placed in caudate nucleus, anterior, medium and posterior putamen and occipital cortex.
Whole striatum 123I-FP-CIT binding ratio was significantly lower in patients than healthy subjects (t = 2.56, p < 0.014). This was observed in whole putamen (t = 2.66, p < 0.011), anterior (t = 2.35, p < 0.023), medium (t = 2.38, p < 0.022) and posterior putamen (t = 2.09, p < 0.042). No differences were observed in caudate nucleus (t = 1.81, p = 0.076). Females obtained higher binding ratios than males (t = -3.13, p < 0.003). No correlation was observed between 123I-FP-CIT binding ratios and clinical scales.
In our series, first episode schizophrenic patients treated with risperidone have a decrease striatal DAT binding assessed with 123I-FP-CIT SPECT. This alteration could be related to their own schizophrenia disease or be secondary to the antipsychotic treatment.
锥体外系症状和帕金森症（PS）是抗精神病药物治疗中常见的副作用。然而，约24%未经治疗的精神分裂症患者可能患有PS，这与普通人群中1%的患病率形成对比。123I-FP-CIT单光子发射计算机断层扫描（SPECT）有助于区分退行性与非退行性PS，因此使用它来确定这些患者突触前多巴胺神经元的功能状态可能会很有意思。
确定一组首次发作的精神分裂症患者的多巴胺转运体结合（DAT）情况。
一项开放性横向研究。招募了30名精神分裂症住院患者和15名健康受试者。患者接受相似剂量的利培酮治疗，所有受试者均接受123I-FP-CIT扫描。通过辛普森-安格斯量表、临床总体印象量表（CGI）和阳性和阴性症状量表（PANSS）评估锥体外系症状和精神病理状态。使用置于尾状核、前壳核、中壳核、后壳核和枕叶皮质的感兴趣区（ROI）对SPECT图像进行半定量分析。
患者全纹状体123I-FP-CIT结合率显著低于健康受试者（t = 2.56，p < 0.014）。在整个壳核（t = 2.66，p < 0.011）、前壳核（t = 2.35，p < 0.023）、中壳核（t = 2.38，p < 0.022）和后壳核（t = 2.09，p < 0.042）均观察到这种情况。尾状核未观察到差异（t = 1.81，p = 0.076）。女性的结合率高于男性（t = -3.13，p < 0.003）。123I-FP-CIT结合率与临床量表之间未观察到相关性。
在我们的研究系列中，接受利培酮治疗的首次发作精神分裂症患者经123I-FP-CIT SPECT评估显示纹状体DAT结合率降低。这种改变可能与其自身的精神分裂症疾病有关，也可能是抗精神病药物治疗的继发结果。
