Kegeles L S, Mann J J
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, USA.
Neuropsychopharmacology. 1997 Nov;17(5):293-307. doi: 10.1016/S0893-133X(97)00069-9.
In vivo functional brain imaging, including global blood flow, regional cerebral blood flow (rCBF), measured with positron emission tomography (PET) and single photon emission computed tomography (SPECT), and regional cerebral metabolic rate (rCMR) measured with deoxyglucose PET, have been widely used in studies of psychiatric disorders. These studies have found modest differences and required large numbers of patients. Activation studies using rCBF or rCMR as indices of neuronal activity are more sensitive because patients act as their own control; however, findings localize regions of change but provide no data about specific neurotransmitter systems. After a general discussion of the role of neurotransmitter systems in neuropsychiatric disorders, an overview of the methodology of development and selection of radioligands for PET and SPECT is presented. Studies involving PET and SPECT ligand methods are reviewed and their findings summarized, including recent work demonstrating successive mutual modulation of neurotransmitter systems. Kinetic and equilibrium analysis modeling are reviewed. The emerging methodology of measuring neurotransmitter release on activation, both pharmacologically and by task performance, using ligand methods is reviewed and proposed as a promising new approach for studying psychiatric disorders.
体内功能性脑成像，包括用正电子发射断层扫描（PET）和单光子发射计算机断层扫描（SPECT）测量的全脑血流量、局部脑血流量（rCBF），以及用脱氧葡萄糖PET测量的局部脑代谢率（rCMR），已广泛应用于精神疾病的研究。这些研究发现了一些细微差异，且需要大量患者。使用rCBF或rCMR作为神经元活动指标的激活研究更具敏感性，因为患者自身作为对照；然而，研究结果确定了变化区域，但未提供有关特定神经递质系统的数据。在对神经递质系统在神经精神疾病中的作用进行一般性讨论之后，本文概述了PET和SPECT放射性配体的开发和选择方法。回顾了涉及PET和SPECT配体方法的研究，并总结了其研究结果，包括最近证明神经递质系统连续相互调节的工作。回顾了动力学和平衡分析模型。本文还回顾了使用配体方法在激活时通过药理学和任务表现测量神经递质释放的新兴方法，并将其作为研究精神疾病的一种有前途的新方法提出。
