Sher Leo, Milak Matthew S, Parsey Ramin V, Carballo Juan J, Cooper Thomas B, Malone Kevin M, Oquendo Maria A, Mann J John
Division of Neuroscience, Department of Psychiatry, Columbia University, New York, NY 10032, USA.
Eur Neuropsychopharmacol. 2007 Sep;17(9):608-15. doi: 10.1016/j.euroneuro.2007.03.007. Epub 2007 May 2.
This is the first study contrasting regional glucose metabolic rate (rCMRglu) responses to a serotonergic challenge in major depressive disorder (MDD) with and without comorbid alcohol dependence. In a university hospital, patients with MDD without a history of alcohol dependence (MDD only) and patients with MDD and comorbid alcohol dependence (MDD/ALC) were enrolled in this study. Subjects with comorbid borderline personality disorder were excluded. A bolus injection of approximately 5 mCi of (18)fluorodeoxyglucose was administered 3 h after the administration of placebo or fenfluramine. We found an anterior medial prefrontal cortical area where MDD/ALC subjects had more severe hypofrontality than MDD only patients. This area encompassed the left medial frontal and left and right anterior cingulate gyri. This group difference disappeared after fenfluramine administration. The fact that the observed group difference disappeared after the fenfluramine challenge suggests that serotonergic mechanisms play a role in the observed differences between the groups.
这是第一项对比伴有和不伴有共病酒精依赖的重度抑郁症（MDD）患者对5-羟色胺能激发试验的局部葡萄糖代谢率（rCMRglu）反应的研究。在一家大学医院，无酒精依赖史的MDD患者（仅MDD）和伴有共病酒精依赖的MDD患者（MDD/ALC）被纳入本研究。共病边缘型人格障碍的受试者被排除。在给予安慰剂或芬氟拉明3小时后，静脉推注约5毫居里的（18）氟脱氧葡萄糖。我们发现一个前额叶内侧皮质区域，MDD/ALC受试者在该区域的额叶功能减退比仅MDD患者更严重。该区域包括左侧额叶内侧以及左侧和右侧前扣带回。在给予芬氟拉明后，该组间差异消失。芬氟拉明激发试验后观察到的组间差异消失这一事实表明，5-羟色胺能机制在两组间观察到的差异中起作用。
