一项使用99mTc-TRODAT-1单光子发射计算机断层扫描-计算机断层扫描（SPECT-CT）对 kratom 依赖者和正常受试者纹状体多巴胺转运体水平的初步研究。
A Pilot Study of the Striatal Dopamine Transporter Levels in Kratom-Dependent and Normal Subjects Using 99mTc-TRODAT-1 Single Photon Emission Computed Tomography-Computed Tomography (SPECT-CT).
作者信息
Zainudin Norasma Amira Binti, Zulkifli Nurul Nadiah, Abdul Hamid Khadijah, Hashim Hazlin, Mansor Syahir
机构信息
Biomedical Imaging, Universiti Sains Malaysia, Penang, MYS.
Nuclear Medicine Unit, Universiti Sains Malaysia, Penang, MYS.
出版信息
Cureus. 2023 Aug 10;15(8):e43251. doi: 10.7759/cureus.43251. eCollection 2023 Aug.
OBJECTIVE
The study aims to elucidate the effects of kratom addiction on dopamine transporter (DAT) using [2-[[2-[[[3-(4-chlorophenyl)-8-methyl-8-azabicyclo[3.2.1]oct-2-yl]methyl](2-mercaptoethyl)amino]ethyl]amino]ethanethiolato(3-)-N2,N20,S2,S20]oxo-[1R-(exo-exo)]-[Tc] technetium (Tc-TRODAT-1) brain single photon emission computed tomography-computed tomography (SPECT-CT) in kratom-dependent and healthy subjects.
MATERIALS AND METHODS
We recruited 12 kratom-dependent subjects and 13 healthy men to participate in this study. Addiction, craving, depression, and cognitive scores were assessed. All subjects received a single bolus injection of Tc-TRODAT-1 with 914.1 MBq ± 65.5 of activity (mean ± SD). The brain SPECT-CT images were reconstructed using 3D ordered subset expectation maximization (3D-OSEM) along with attenuation correction (AC), scatter correction (SC), and resolution recovery (RR) with an iteration number of four and a subset of 10. The Cohen's Kappa interrater-reliability between two raters, the standardized uptake value of body weight (SUV), and the asymmetrical index percentage (AI%) were evaluated.
RESULTS
Kappa statistics showed a fine agreement of abnormal Tc-TRODAT-1 uptake in the striatum region for the kratom-dependent group with the κ value of 0.69 (p = 0.0001), and the percentage of agreement for rater 1 and rater 2 was 56% and 64%, respectively. There was a reduction in average SUV in kratom-dependent subjects compared to healthy control subjects in the left caudate and left striatum (0.938 vs. 1.251, p = 0.014, and 1.055 vs. 1.29, p = 0.036, respectively). There was a significant difference in the AI% of the caudate region between the kratom-dependent group and the normal group (33% vs. 14%, p = 0.019).
CONCLUSION
Our findings signify that kratom addiction, may cause a change in DAT level and the results can be confirmed using Tc-TRODAT-1 SPECT-CT.
目的
本研究旨在通过[2-[[2-[[[3-(4-氯苯基)-8-甲基-8-氮杂双环[3.2.1]辛-2-基]甲基](2-巯基乙基)氨基]乙基]氨基]乙硫醇盐(3-)-N2,N20,S2,S20]氧代-[1R-(外向-外向)]-[锝]锝（Tc-TRODAT-1）脑单光子发射计算机断层扫描-计算机断层扫描（SPECT-CT），阐明 kratom 成瘾对多巴胺转运体（DAT）的影响，研究对象为 kratom 依赖者和健康受试者。
材料与方法
我们招募了 12 名 kratom 依赖者和 13 名健康男性参与本研究。评估成瘾、渴望、抑郁和认知得分。所有受试者均接受单次静脉注射 Tc-TRODAT-1，活度为 914.1 MBq±65.5（均值±标准差）。使用三维有序子集期望最大化（3D-OSEM）结合衰减校正（AC）、散射校正（SC）和分辨率恢复（RR）重建脑 SPECT-CT 图像，迭代次数为 4，子集数为 10。评估两名评分者之间的 Cohen's Kappa 评分者间信度、体重标准化摄取值（SUV）和不对称指数百分比（AI%）。
结果
Kappa 统计显示，kratom 依赖组纹状体区域 Tc-TRODAT-1 摄取异常的一致性良好，κ值为 0.69（p = 0.0001），评分者 1 和评分者 2 的一致性百分比分别为 56%和 64%。与健康对照受试者相比，kratom 依赖者左尾状核和左纹状体的平均 SUV 降低（分别为 0.938 对 1.251，p = 0.014；1.055 对 1.29，p = 0.036）。kratom 依赖组和正常组尾状核区域的 AI%存在显著差异（33%对 14%，p = 0.019）。
结论
我们的研究结果表明，kratom 成瘾可能导致 DAT 水平发生变化，且使用 Tc-TRODAT-1 SPECT-CT 可证实该结果。
Zotero 插件