Tune L E, Wong D F, Pearlson G, Strauss M, Young T, Shaya E K, Dannals R F, Wilson A A, Ravert H T, Sapp J
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD.
Psychiatry Res. 1993 Dec;49(3):219-37. doi: 10.1016/0165-1781(93)90063-m.
Positron emission tomography (PET) with 11C-N-methylspiperone as the radioligand was carried out in 25 chronic schizophrenic patients to determine dopamine D2 receptor density estimates in the corpus striatum. The sample included 18 neuroleptic-naive and 7 neuroleptic-free patients. Dopamine D2 receptor density estimates (Bmax) were obtained using a two-scan/four-compartment model. The Bmax estimates for the entire group (33.39 +/- 3.43 pmole/g) were significantly elevated when compared with estimates for the control group (Bmax = 15.63 +/- 2.38). The Bmax values for the entire group of schizophrenic patients showed a significant decline as a function of age. The Bmax values were significantly related to duration of illness (y = 13.2 + 10.3795x - 0.7931x2; r = 0.48). Thirteen patients and seven control subjects were added to our original publication sample (Wong et al., 1986c). The patients' Bmax values, when adjusted for age and sex effects, were significantly different compared with those of control subjects. Clinical data from the entire group were compared with published data from other research groups that have estimated dopamine D2 receptor density using different radioligands and different methods of data analysis. Comparisons of the clinical characteristics of the published studies show significant differences in patient populations, suggesting that discrepancies among published studies may reflect, in part, heterogeneity among groups of schizophrenic patients. The D2 receptor abnormality described in this study may be a late manifestation of disease, and the implications of this observation are discussed.
以¹¹C-N-甲基螺哌隆作为放射性配体,对25例慢性精神分裂症患者进行了正电子发射断层扫描(PET),以测定纹状体中多巴胺D₂受体密度估计值。样本包括18例未使用过抗精神病药物的患者和7例已停用抗精神病药物的患者。使用双扫描/四室模型获得多巴胺D₂受体密度估计值(Bmax)。与对照组估计值(Bmax = 15.63 ± 2.38)相比,整个研究组的Bmax估计值(33.39 ± 3.43 pmol/g)显著升高。精神分裂症患者整个研究组的Bmax值随年龄增长呈显著下降。Bmax值与病程显著相关(y = 13.2 + 10.3795x - 0.7931x²;r = 0.48)。在我们最初发表的样本(Wong等人,1986c)基础上又增加了13例患者和7例对照受试者。在对年龄和性别效应进行校正后,患者的Bmax值与对照受试者的Bmax值存在显著差异。将整个研究组的临床数据与其他研究组已发表的数据进行了比较,这些研究组使用不同的放射性配体和不同的数据分析方法来估计多巴胺D₂受体密度。已发表研究的临床特征比较显示,患者群体存在显著差异,这表明已发表研究之间的差异可能部分反映了精神分裂症患者群体的异质性。本研究中描述的D₂受体异常可能是疾病的晚期表现,并对这一观察结果的意义进行了讨论。