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进食障碍:正电子发射断层扫描和单光子发射计算机断层扫描有作用吗?文献系统评价。

Eating disorders: Do PET and SPECT have a role? A systematic review of the literature.

机构信息

Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.

出版信息

Psychiatry Res Neuroimaging. 2020 Jun 30;300:111065. doi: 10.1016/j.pscychresns.2020.111065. Epub 2020 Mar 12.

Abstract

A systematic review was implemented according to PRISMA guidelines on Pubmed, Psychinfo, Medline, Embase to fill the existing literature gap on the effectiveness of using Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) in Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED). Twenty-two articles were included. Four studies reported an increased density in 5-hydroxytryptamine receptor (5-HT) in fronto-temporo-parietal regions in both affected and recovered AN as well as in BN. The 5-HT transporter (5-HTT) binding was increased or diminished in different specific cortical areas and in relation to Eating Disorder (ED) subtypes. Some evidences of blunted Dopamine (DA) release in the putamen in BN patients suggest that their DA function might be impaired as in addictive behaviours. Studies estimating the regional Cerebral Blood Flow (rCBF) with SPECT demonstrated that temporal areas seem to play a key role in ED corroborating the hypothesis of a cingulate-temporal cortical dysfunction in AN. In addition, alterations of both parietal and prefrontal cortex provide a possible common neural substrate in AN. Studies included in this review are heterogeneous preventing robust conclusions, however, our findings add knowledge on some of the neurotransmitters involved in ED.

摘要

根据 PRISMA 指南,在 Pubmed、Psychinfo、Medline、Embase 上进行了系统评价,以填补关于正电子发射断层扫描 (PET) 和单光子发射计算机断层扫描 (SPECT) 在神经性厌食症 (AN)、贪食症 (BN) 和暴食障碍 (BED) 中的有效性的现有文献空白。共纳入 22 篇文章。四项研究报告称,在受影响和恢复的 AN 以及 BN 中,5-羟色胺受体 (5-HT) 在额颞顶枕区域的密度增加。5-羟色胺转运蛋白 (5-HTT) 的结合在不同的特定皮质区域增加或减少,与饮食失调 (ED) 亚型有关。BN 患者纹状体中多巴胺 (DA) 释放迟钝的一些证据表明,他们的 DA 功能可能受损,就像在成瘾行为中一样。使用 SPECT 估计局部脑血流 (rCBF) 的研究表明,颞叶区域似乎在 ED 中起着关键作用,这支持了 AN 中扣带回-颞叶皮质功能障碍的假说。此外,顶叶和前额叶皮层的改变为 AN 中的可能提供了一个共同的神经基础。本综述中纳入的研究具有异质性,无法得出可靠的结论,但我们的发现增加了一些涉及 ED 的神经递质的知识。

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