Itagaki Shuntaro, Ohnishi Takashi, Toda Wataru, Sato Aya, Matsumoto Junya, Ito Hiroshi, Ishii Shiro, Yamakuni Ryo, Miura Itaru, Yabe Hirooki
Department of Neuropsychiatry Fukushima Medical University Fukushima Japan.
Medical Affairs Division Janssen Pharmaceutical K.K Tokyo Japan.
PCN Rep. 2024 Feb 18;3(1):e177. doi: 10.1002/pcn5.177. eCollection 2024 Mar.
This study aimed to clarify the abnormalities in dopamine transporter (DAT) availability in drug-naive adult patients with attention-deficit/hyperactivity disorder (ADHD) and the relationship between ADHD symptoms and abnormalities in DAT availability.
Single-photon emission tomography (SPECT) was performed using iodine-123-β-carbomethoxy-3β-(4-iodophenyltropane) (I-123 β CIT) as a tracer to measure in vivo DAT availability in 20 drug-naive patients with ADHD [mean age ± standard deviation (SD)]: 25 ± 3.44 years; male:female = 11:9] and 20 age- and sex-matched healthy controls (HCs) (mean age ± SD: 23.9 ± 2.27 years). Comparisons of DAT availability between HCs and adult patients with ADHD and the association between symptom severity and DAT availability within the ADHD group were analyzed using Statistical Parametric Mapping 12.
Drug-naive adults with ADHD showed significantly reduced DAT availability in the bilateral nucleus accumbens compared with HCs. Correlation analyses revealed a negative correlation between the severity of inattentive symptoms in adult patients with ADHD and DAT availability in the bilateral heads of the caudate nucleus, indicating the association between severe inattentive symptoms and lower DAT availability in the caudate nucleus.
In drug-naive adult patients with ADHD, DAT availability was reduced in the nucleus accumbens, an important part of the reward system. This finding indicates the importance of the DAT in the reward system in the pathogenesis of ADHD. Inattentiveness was associated with DAT availability in the caudate nucleus, suggesting involvement of the cortico-striato-thalamo-cortical circuit.
本研究旨在阐明未经药物治疗的成人注意力缺陷多动障碍（ADHD）患者多巴胺转运体（DAT）可用性的异常情况，以及ADHD症状与DAT可用性异常之间的关系。
使用碘-123-β-羧甲氧基-3β-（4-碘苯基）托烷（I-123 β CIT）作为示踪剂进行单光子发射断层扫描（SPECT），以测量20例未经药物治疗的ADHD患者[平均年龄±标准差（SD）：25±3.44岁；男∶女 = 11∶9]和20例年龄及性别匹配的健康对照者（HCs）（平均年龄±SD：23.9±2.27岁）体内的DAT可用性。使用统计参数映射12分析HCs与成年ADHD患者之间DAT可用性的比较，以及ADHD组内症状严重程度与DAT可用性之间的关联。
与HCs相比，未经药物治疗的成年ADHD患者双侧伏隔核的DAT可用性显著降低。相关性分析显示，成年ADHD患者注意力不集中症状的严重程度与双侧尾状核头部的DAT可用性呈负相关，表明严重的注意力不集中症状与尾状核中较低的DAT可用性之间存在关联。
在未经药物治疗的成年ADHD患者中，奖励系统的重要组成部分伏隔核的DAT可用性降低。这一发现表明DAT在ADHD发病机制的奖励系统中具有重要作用。注意力不集中与尾状核中的DAT可用性有关，提示皮质-纹状体-丘脑-皮质回路的参与。
