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戒酒者脑葡萄糖代谢的恢复

Recovery of brain glucose metabolism in detoxified alcoholics.

作者信息

Volkow N D, Wang G J, Hitzemann R, Fowler J S, Overall J E, Burr G, Wolf A P

机构信息

Medical Department, Brookhaven National Laboratory, Upton, NY 11973.

出版信息

Am J Psychiatry. 1994 Feb;151(2):178-83. doi: 10.1176/ajp.151.2.178.

DOI:10.1176/ajp.151.2.178
PMID:8296885
Abstract

OBJECTIVE

To differentiate withdrawal-related abnormalities in brain glucose metabolism among alcoholics from abnormalities that may be irreversible or antedate alcohol use, the authors evaluated metabolic recovery during alcohol detoxification.

METHOD

Regional brain glucose metabolism was measured with positron emission tomography and 2-deoxy-2-[18F]fluoro-D-glucose in 10 male alcoholics at 8-15 days, 16-30 days, and 31-60 days after last use of alcohol. The alcoholics' metabolic values were compared with those of 10 age-matched male healthy volunteers.

RESULTS

Brain metabolism increased significantly during detoxification. There were significant differences in global and regional measures between the first and last time points but not between the second and third points, suggesting that recovery occurred predominantly within 16-30 days. Regional increases in metabolism were greater in the frontal regions. Whereas during the first evaluation the alcoholics showed significantly lower metabolism in various brain regions than the comparison group, at the end of detoxification the alcoholics showed significantly lower absolute and relative metabolic values in the basal ganglia and lower relative metabolic values in the parietal cortex. Among the alcoholics, but not the comparison group, metabolism in the frontal, parietal, and left temporal cortexes was negatively correlated with years of alcohol use and with age.

CONCLUSIONS

This study shows significant increases in brain metabolism during alcohol withdrawal and documents persistent low metabolic levels in the basal ganglia of detoxified alcoholics.

摘要

目的

为了区分酗酒者大脑葡萄糖代谢中与戒断相关的异常情况和可能不可逆转或早于饮酒出现的异常情况,作者评估了酒精戒断期间的代谢恢复情况。

方法

使用正电子发射断层扫描和2-脱氧-2-[18F]氟-D-葡萄糖对10名男性酗酒者在最后一次饮酒后的8 - 15天、16 - 30天和31 - 60天测量大脑区域葡萄糖代谢。将酗酒者的代谢值与10名年龄匹配的男性健康志愿者的代谢值进行比较。

结果

戒断期间大脑代谢显著增加。第一次和最后一次测量的整体和区域测量值存在显著差异,但第二次和第三次测量之间没有显著差异,这表明恢复主要发生在16 - 30天内。额叶区域的代谢增加更为明显。在第一次评估时,酗酒者在各个脑区的代谢显著低于对照组,但在戒断结束时,酗酒者在基底神经节的绝对和相对代谢值显著较低,在顶叶皮质的相对代谢值较低。在酗酒者中,而非对照组中,额叶、顶叶和左侧颞叶皮质的代谢与饮酒年限和年龄呈负相关。

结论

本研究显示酒精戒断期间大脑代谢显著增加,并记录了戒酒后酗酒者基底神经节持续的低代谢水平。

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