Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan
Department of Neuropsychiatry, Okayama University Faculty of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan.
BMJ Ment Health. 2024 Jul 30;27(1):e301042. doi: 10.1136/bmjment-2024-301042.
It has been reported that patients with geriatric psychiatric disorders include many cases of the prodromal stages of neurodegenerative diseases. Abnormal I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane dopamine transporter single-photon emission computed tomography (DAT-SPECT) reveals a nigrostriatal dopaminergic deficit and is considered useful to detect dementia with Lewy bodies and Parkinson's disease as well as progressive supranuclear palsy and corticobasal degeneration. We aimed to determine the proportion of cases that are abnormal on DAT-SPECT in patients with geriatric psychiatric disorders and to identify their clinical profile.
The design is a cross-sectional study. Clinical findings of 61 inpatients aged 60 years or older who underwent DAT-SPECT and had been diagnosed with psychiatric disorders, but not neurodegenerative disease or dementia were analysed.
36 of 61 (59%) had abnormal results on DAT-SPECT. 54 of 61 patients who had DAT-SPECT (89%) had undergone I-metaiodobenzylguanidine myocardial scintigraphy (I-MIBG scintigraphy); 12 of the 54 patients (22.2%) had abnormal findings on I-MIBG scintigraphy. There were no cases that were normal on DAT-SPECT and abnormal on I-MIBG scintigraphy. DAT-SPECT abnormalities were more frequent in patients with late-onset (55 years and older) psychiatric disorders (69.0%) and depressive disorder (75.7%), especially late-onset depressive disorder (79.3%).
Patients with geriatric psychiatric disorders include many cases showing abnormalities on DAT-SPECT. It is suggested that these cases are at high risk of developing neurodegenerative diseases characterised by a dopaminergic deficit. It is possible that patients with geriatric psychiatric disorders with abnormal findings on DAT-SPECT tend to show abnormalities on DAT-SPECT first rather than on I-MIBG scintigraphy.
据报道，老年精神病患者包括许多神经退行性疾病前驱期患者。异常的 I-2β- 碳甲氧基-3β-(4- 碘苯基)-N-(3- 氟丙基)去甲托烷多巴胺转运体单光子发射计算机断层扫描（DAT-SPECT）显示出黑质纹状体多巴胺能缺陷，被认为有助于检测路易体痴呆、帕金森病以及进行性核上性麻痹和皮质基底节变性。我们旨在确定老年精神病患者 DAT-SPECT 异常的比例，并确定其临床特征。
这是一项横断面研究。分析了 61 名年龄在 60 岁或以上、接受 DAT-SPECT 检查且被诊断为精神病但无神经退行性疾病或痴呆的住院患者的临床发现。
61 名患者中有 36 名（59%）DAT-SPECT 结果异常。61 名接受 DAT-SPECT 的患者中有 54 名（89%）进行了 I-间碘苄胍心肌闪烁显像（I-MIBG 闪烁显像）；54 名患者中有 12 名（22.2%）I-MIBG 闪烁显像异常。没有 DAT-SPECT 正常而 I-MIBG 闪烁显像异常的病例。DAT-SPECT 异常在晚发性（55 岁及以上）精神病（69.0%）和抑郁症（75.7%）患者中更为常见，尤其是晚发性抑郁症（79.3%）。
老年精神病患者包括许多 DAT-SPECT 异常的病例。这些病例可能有发生以多巴胺能缺陷为特征的神经退行性疾病的高风险。DAT-SPECT 异常的老年精神病患者可能首先表现出 DAT-SPECT 异常，而不是 I-MIBG 闪烁显像异常。
