Department of Psychiatry, Faculty of Health Sciences, University of Stellenbosch, P.O. Box 19063, Tygerberg 7505, Cape Town, South Africa.
Metab Brain Dis. 2012 Mar;27(1):67-77. doi: 10.1007/s11011-011-9273-7. Epub 2011 Dec 7.
Alcohol-induced psychotic disorder (AIPD) also known as alcohol hallucinosis is a rare complication of alcohol abuse. The pathogenesis and treatment of AIPD are still unclear. Few prospective treatment studies are available but case reports generally suggest that anti-psychotic treatment is effective. Brain imaging changes in relation to treatment response have also not been studied except for case reports. The aim of this study was to investigate the effect of anti-psychotic treatment on psychopathology and regional cerebral blood flow (rCBF) in patients with AIPD before and after 6 weeks of treatment. Nineteen patients with AIPD were assessed by the Positive and Negative Syndrome Scale (PANSS) and single photon emission computed tomography (SPECT) before and after 6-weeks of open-label treatment with a fixed dose of haloperidol (5 mg/day). Highly significant improvements were noted on the positive, general and total scores of the PANSS. Post-treatment increased rCBF to the left caudate and left frontal lobe was noted. Changes in frontal, temporal, parietal, occipital, thalamic and cerebellar rCBF showed significant negative correlations with the degree of symptom improvement, suggesting dysfunction of these areas in AIPD. Psychopathological and rCBF findings suggest reversible generalised cerebral dysfunction in AIPD.
酒精所致精神病性障碍（AIPD）又称酒精性幻觉症，是酒精滥用的罕见并发症。AIPD 的发病机制和治疗仍不清楚。虽然有一些前瞻性治疗研究，但大多数是病例报告，一般认为抗精神病治疗有效。除了病例报告，目前还没有研究治疗反应与脑影像变化之间的关系。本研究旨在探讨抗精神病治疗对 AIPD 患者治疗前和治疗后 6 周时精神病理学和局部脑血流（rCBF）的影响。19 例 AIPD 患者在接受为期 6 周的开放性、固定剂量氟哌啶醇（5mg/天）治疗前后，采用阳性和阴性症状量表（PANSS）和单光子发射计算机断层扫描（SPECT）进行评估。PANSS 的阳性、一般和总分均有显著改善。治疗后发现左侧尾状核和左侧额叶 rCBF 增加。额叶、颞叶、顶叶、枕叶、丘脑和小脑 rCBF 的变化与症状改善程度呈显著负相关，提示 AIPD 中这些区域存在功能障碍。精神病理学和 rCBF 研究结果提示 AIPD 存在可逆转的广泛脑功能障碍。
