Affective Disorders Unit, Department of Psychiatry, School of Medicine, 35100 Bornova, Izmir, Turkey.
Int Rev Psychiatry. 2009;21(4):323-35. doi: 10.1080/09540260902962131.
The basic concepts of positron emission tomography (PET) and single photon emission computed tomography (SPECT) scanning are introduced, and the two modalities are compared. Applications to bipolar disorder (BD) are reviewed. Regional cerebral metabolic rate and blood flow, often used as surrogate measures of neuronal synaptic activity, are increased in the frontal lobes in both unipolar and bipolar depression. In mania, metabolism increases in the dorsal cingulate cortex, striatal regions, and the nucleus accumbens, as well as in limbic structures of the temporal lobes, but decreases in dorsolateral prefrontal cortex, possibly reflecting its loss of modulatory control over limbic structures. Specifically targeted PET radioligands are used to investigate neurotransmitter systems. D1 receptor binding potentials are reduced in frontal cortex, but striatal D2 receptor density is normal in all phases of non-psychotic BD. Psychotic BD patients show higher D2 receptor densities in the caudate, which correlate with the degree of psychosis but not mood symptoms. The serotonin transporter shows increased density in the thalamus, dorsal cingulate cortex, medial preftontal cortex, and insula of depressed BD patients. In the dorsal cingulate cortex and insula, it correlates with anxiety (and in the cingulate, with suicide attempts).
正电子发射断层扫描（PET）和单光子发射计算机断层扫描（SPECT）扫描的基本概念被引入，并对这两种模式进行了比较。对双相障碍（BD）的应用进行了回顾。区域脑代谢率和血流，通常作为神经元突触活动的替代测量，在单相和双相抑郁的额叶中增加。在躁狂症中，代谢在背侧扣带皮质、纹状体区域和伏隔核中增加，以及在颞叶的边缘结构中增加，但在背外侧前额叶皮质中减少，这可能反映了其对边缘结构的调节控制的丧失。专门针对 PET 放射性配体用于研究神经递质系统。D1 受体结合潜能在额叶中减少，但在所有非精神病性 BD 阶段，纹状体 D2 受体密度正常。精神病性 BD 患者在尾状核中显示出更高的 D2 受体密度，与精神病程度相关，但与情绪症状无关。在抑郁性 BD 患者的丘脑、背侧扣带皮质、内侧前额皮质和岛叶中，血清素转运体显示出密度增加。在背侧扣带皮质和岛叶中，它与焦虑（在扣带中，与自杀企图）相关。
