Apostolova Ivayla, Hellwig Sabine, Karimzadeh Amir, Klutmann Susanne, Meyer Philipp T, Buchert Ralph
Department of Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Freiburg, Germany.
Eur J Nucl Med Mol Imaging. 2025 Mar;52(4):1549-1555. doi: 10.1007/s00259-024-06989-z. Epub 2024 Nov 30.
This study examined the impact of venlafaxine and bupropion on the detection of nigrostriatal degeneration by dopamine transporter (DAT)-SPECT.
43 patients (70.7 ± 8.6y, 44% female) with [I]FP-CIT-SPECT under venlafaxine (n = 26, 37.5-225 mg/d), bupropion (n = 16, 150 or 300 mg/d) or both (n = 1) were included retrospectively. The striatal specific [I]FP-CIT binding ratio (SBR), its left-right asymmetry and the putamen-to-caudate ratio were transformed to z-scores and submitted to a cluster analysis for data-driven categorization.
Two clusters were identified. The first cluster (37% cases) showed a Parkinson's disease (PD)-like pattern: median striatal SBR/asymmetry/putamen-to-caudate z-score -4.5/4.9/-3.8. The second cluster (63%) showed symmetric reduction with normal intra-striatal gradient: median striatal SBR/asymmetry/putamen-to-caudate z-score -2.7/0.4/0.2. Patients with follow-up clinical reference diagnoses of neurodegenerative (n = 8) and non-neurodegenerative (n = 16) parkinsonism fell exclusively into the former or the latter cluster, respectively (p < 0.001).
Venlafaxine and bupropion cause uniform reduction of the striatal [I]FP-CIT SBR that can be distinguished from PD-like reductions.
本研究探讨了文拉法辛和安非他酮对多巴胺转运体（DAT）单光子发射计算机断层扫描（SPECT）检测黑质纹状体变性的影响。
回顾性纳入43例患者（年龄70.7±8.6岁，44%为女性），这些患者接受了[I]FP-CIT-SPECT检查，其中服用文拉法辛（n = 26，37.5 - 225mg/d）的有26例，服用安非他酮（n = 16，150或300mg/d）的有16例，同时服用两者（n = 1）的有1例。将纹状体特异性[I]FP-CIT结合率（SBR）、其左右不对称性以及壳核与尾状核的比值转换为z分数，并进行聚类分析以进行数据驱动的分类。
识别出两个聚类。第一个聚类（37%的病例）呈现出帕金森病（PD）样模式：纹状体SBR/不对称性/壳核与尾状核z分数的中位数为-4.5/4.9/-3.8。第二个聚类（63%）表现为对称性降低且纹状体内梯度正常：纹状体SBR/不对称性/壳核与尾状核z分数的中位数为-2.7/0.4/0.2。随访临床参考诊断为神经退行性帕金森综合征（n = 8）和非神经退行性帕金森综合征（n = 16）的患者分别完全归入前者或后者聚类（p < 0.001）。
文拉法辛和安非他酮会导致纹状体[I]FP-CIT SBR均匀降低，这可以与PD样降低相区分。
