Makkonen I, Kokki H, Kuikka J, Turpeinen U, Riikonen R
Department of Pediatrics, Unit of Child Neurology, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
Neuropediatrics. 2011 Oct;42(5):207-9. doi: 10.1055/s-0031-1291242. Epub 2011 Oct 20.
A positive effect of fluoxetine has been shown in some children with autism. The present study was undertaken to correlate striatal dopamine transporter (DAT) binding and cerebrospinal fluid insulin-like growth factor-1 (CSF-IGF-1) with clinical response in autistic children (n=13, age 5-16 years) after a 6-month fluoxetine treatment. Good clinical responders (n=6) had a decrease (p=0.031) in DAT binding as assessed using single-photon emission computed tomography with [123I]-nor-β-CIT, whereas poor responders had a trend to an increase. An increase in CSF-IGF-1 (p=0.003) was detected after the treatment period, but no correlation between the clinical response and CSF-IGF-1 was found. In conclusion, fluoxetine decreases DAT binding indicating alleviation of the hyperdopaminergic state and increases CSF-IGF-1 concentration, which may also have a neuroprotective effect against dopamine-induced neurotoxicity in autistic children.
氟西汀已在一些自闭症儿童中显示出积极效果。本研究旨在探讨自闭症儿童（n = 13，年龄5 - 16岁）在接受6个月氟西汀治疗后，纹状体多巴胺转运体（DAT）结合与脑脊液胰岛素样生长因子-1（CSF-IGF-1）与临床反应之间的相关性。使用[123I]-去甲-β-CIT单光子发射计算机断层扫描评估，良好临床反应者（n = 6）的DAT结合减少（p = 0.031），而反应不佳者有增加的趋势。治疗期后检测到CSF-IGF-1增加（p = 0.003），但未发现临床反应与CSF-IGF-1之间存在相关性。总之，氟西汀降低DAT结合表明高多巴胺能状态得到缓解，并增加CSF-IGF-1浓度，这可能对自闭症儿童多巴胺诱导的神经毒性也具有神经保护作用。
