Department of Education and Research, Taipei City Hospital Renai Branch, Taipei, Taiwan.
Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.
Psychiatry Res Neuroimaging. 2019 Oct 30;292:23-31. doi: 10.1016/j.pscychresns.2019.06.002. Epub 2019 Jun 22.
Methamphetamine is a highly addictive psychostimulant. A subset of methamphetamine users develops methamphetamine-associated psychosis (MAP), which causes poorer prognoses and cognitive function than those with no psychosis (MNP). Comprehensive and integrative summaries of studies utilizing various neuroimaging modalities (structural, functional, and neurochemical) are limited. We conducted a systematic review of literature regarding clinical neuroimaging research published between January 1988 and July 2018 using the PubMed, Web of Science, Scopus, and ScienceDirect databases. Studies comparing the neuroimaging of patients with MAP with healthy controls or patients with MNP or schizophrenia were included to understand the distinct profiles associated with MAP. A total of six structural, three functional, and three neurochemical studies were reviewed. A general trend was identified that showed MAP-related brain alterations were mainly in the frontal lobe (especially the orbitofrontal cortex), striatum, and limbic systems (amygdala and hippocampus). Furthermore, some clinical manifestations, such as the severity of psychotic symptoms and cognitive performance, were correlated with neuroimaging abnormalities. In summary, distinct structural, functional, and neurochemical changes, especially in the frontostriatal circuit and network dynamic systems, play critical roles in the pathophysiology of MAP. Future studies using longitudinal study designs and including individuals with MNP and schizophrenia as controls are warranted.
甲基苯丙胺是一种高度成瘾的精神兴奋剂。一部分甲基苯丙胺使用者会出现与甲基苯丙胺相关的精神病（MAP），这会导致比没有精神病（MNP）的患者预后和认知功能更差。利用各种神经影像学模式（结构、功能和神经化学）进行的综合研究综述有限。我们对 1988 年 1 月至 2018 年 7 月期间发表的关于临床神经影像学研究的文献进行了系统回顾，使用了 PubMed、Web of Science、Scopus 和 ScienceDirect 数据库。我们纳入了比较 MAP 患者与健康对照者或 MNP 或精神分裂症患者的神经影像学研究，以了解与 MAP 相关的独特特征。共综述了 6 项结构研究、3 项功能研究和 3 项神经化学研究。总的来说，有一个普遍的趋势表明，MAP 相关的大脑改变主要发生在额叶（特别是眶额皮层）、纹状体和边缘系统（杏仁核和海马体）。此外，一些临床表现，如精神病症状的严重程度和认知表现，与神经影像学异常相关。总之，独特的结构、功能和神经化学变化，特别是在额纹状体回路和网络动态系统中，在 MAP 的病理生理学中起着关键作用。未来的研究需要使用纵向研究设计，并将 MNP 和精神分裂症患者作为对照。
