Yeh Chin-Bin, Lee Chiang-Hsuan, Chou Yuan-Hwa, Chang Chia-Jung, Ma Kuo-Hsing, Huang Wen-Sheng
Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan, ROC.
Nucl Med Commun. 2006 Oct;27(10):779-84. doi: 10.1097/01.mnm.0000239485.53780.16.
Findings on imaging of dopamine transporter (DAT) activity in patients with Tourette's syndrome remain inconclusive. The present study was carried out to observe DAT activity in patients with well-controlled Tourette's syndrome by using (99m)Tc-TRODAT-1 single photon emission computerized tomography (SPECT).
Six drug-naive patients with Tourette's syndrome (mean age+/-SD, 21.2+/-1.5 years) were recruited. All met the criteria for Tourette's syndrome established in the DSM-IV. Seventeen age-matched and sex-matched healthy subjects served as the controls. Brain SPECT were acquired 165-195 min after administrating 740 MBq of (99m)Tc-TRODAT-1, using a double-headed camera equipped with ultra-high-resolution fan-beam collimators. The specific uptake ratio was calculated by subtracting the mean counts per pixel in the occipital cortex from the mean counts per pixel in the striatum, putamen or caudate nucleus and by dividing the result by the mean counts per pixel in the occipital cortex. Tic-severity scores were also measured and correlated with the specific uptake ratios.
No significant difference in DAT activity between patients with Tourette's syndrome and control subjects was found in the striatum and its sub-regions. Tic-severity scores were also not correlated with specific uptake ratios measured from the striatum and its sub-regions.
In conjunction with previous findings, our results suggested that functional abnormality of the dopamine system in patients with Tourette's syndrome might be evident only in its early stage. Adaptation to tic symptoms might play a role in regulating the neural system.
抽动秽语综合征患者多巴胺转运体(DAT)活性的影像学研究结果尚无定论。本研究旨在通过使用(99m)Tc-TRODAT-1单光子发射计算机断层扫描(SPECT)观察抽动秽语综合征病情得到良好控制的患者的DAT活性。
招募了6例未服用过药物的抽动秽语综合征患者(平均年龄±标准差,21.2±1.5岁)。所有患者均符合《精神疾病诊断与统计手册》第四版(DSM-IV)中确立的抽动秽语综合征标准。17名年龄和性别匹配的健康受试者作为对照。在静脉注射740MBq的(99m)Tc-TRODAT-1后165 - 195分钟,使用配备超高分辨率扇形束准直器的双头相机进行脑SPECT检查。通过从纹状体、壳核或尾状核的每像素平均计数中减去枕叶皮质的每像素平均计数,并将结果除以枕叶皮质的每像素平均计数来计算特异性摄取率。还测量了抽动严重程度评分,并将其与特异性摄取率进行相关性分析。
在纹状体及其亚区域中,抽动秽语综合征患者与对照受试者之间的DAT活性没有显著差异。抽动严重程度评分也与纹状体及其亚区域测量的特异性摄取率无关。
结合先前的研究结果,我们的结果表明,抽动秽语综合征患者多巴胺系统的功能异常可能仅在早期阶段明显。对抽动症状的适应可能在调节神经系统中起作用。