A fenfluramine-activated FDG-PET study of borderline personality disorder
A fenfluramine-activated FDG-PET study of borderline personality disorder
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DOI：
10.1016/s0006-3223(99)00202-4
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发表时间：
2000-03-15
影响因子：
10.6
通讯作者：
Kelly, TM
中科院分区：
文献类型：
--
作者：
Soloff, PH;Meltzer, CC;Kelly, TM
背景：人格障碍患者的冲动性攻击性与脑脊液S-HIAA水平降低、对5-羟色胺能激动剂的神经内分泌反应迟钝以及前额叶皮质葡萄糖利用减少有关。在用L芬氟拉明(FEN)进行药物激发时，我们利用正电子发射断层扫描(PET)神经成像技术，验证了交界性人格障碍(BPD)的冲动性攻击行为可能与前额叶皮质5-羟色胺能调节减弱有关的假说。方法：对5例BPD患者和8名健康对照受试者进行了为期2天的单盲、安慰剂对照的FEN激发研究。第1天，4mCI[F-18]-脱氧葡萄糖(FDG)在服用安慰剂3h后注射；在第2天，FDG在每日0.8 mg/kg~60 mg/kg剂量下注射给L芬氟拉明。30分钟后，在西门子/CTI 951R/31扫描仪上进行45分钟的发射扫描。结果：在安慰剂作用下，对照组受试者前额叶皮质的FDG摄取高于双侧额叶皮质(包括双侧IBA 10-11)的内侧和眼眶区域。与对照组参与者相比，患者没有哪个区域的相对摄取率更高。与右侧前额叶(BA10)、左侧颞叶中上回(BA22-23)、左侧顶叶IBA40和左侧尾状体区的患者相比，中央受试者对FDG的相对区域摄取(相对于安慰剂)更大。结论：BPD患者在与冲动行为调节相关的前额叶皮质区域对5-羟色胺能刺激的反应减弱。(C)2000年生物精神病学学会。
Background: Impulsive aggression in patients with personality disorders is associated with diminished levels of cerebrospinal fluid (CSF) S-HIAA, blunted neuroendocrine responses to serotonergic agonists, and decreased glucose utilization in the prefrontal cortex. We tested the hypothesis that impulsive aggression in borderline personality disorder (BPD) may lie associated with diminished serotonergic regulation in the prefrontal cortex, using positron-emission tomography (PET) neuroimaging during pharmacologic challenge with d,l fenfluramine (FEN).Methods: A 2-day, single-blind placebo-controlled FEN challenge study was conducted in five patients with BPD land no Axis I MDD) and eight healthy control participants. On Day 1, 4 mCi [F-18]-fluorodeoxyglucose (FDG) was injected 3 hours after ingestion of placebo; on Day 2, FDG was injected 3 hours after ingestion of .8 mg/kg to 60 mg of d,l fenfluramine. After 30 min, a 45-min emission scan was acquired on the Siemans/CTI 951r/31 scanner. PET data were aligned to MR images and analyzed by Statistical Parametric Mapping (SPM96).Results: In response to placebo, uptake of FDG was greater in control participants than patients in large areas of the prefrontal cortex including medial and orbital regions bilaterally IBA 10-11) left superior temporal gyrus, and right insular cortex. There were no areas in which patients had greater relative regional uptake than control participants. In response to FEN, relative regional uptake of FDG (relative to placebo) was greater in central participants compared to patients in medial and orbital regions of right prefrontal cortex (BA 10), left middle and superior temporal gyri (BA 22-23), left parietal lobe IBA 40), and left caudate body.Conclusions: Patients with BPD have diminished response to serotonergic stimulation in areas of prefrontal cortex associated with regulation of impulsive behaviour. (C) 2000 Society of Biological Psychiatry.