Structural and metabolic brain changes in the striatum associated with methamphetamine abuse
Structural and metabolic brain changes in the striatum associated with methamphetamine abuse
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DOI：
10.1111/j.1360-0443.2006.01782.x
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发表时间：
2007-04-01
期刊：
影响因子：
6
通讯作者：
Volkow, Nora
中科院分区：
文献类型：
--
作者：
Chang, Linda;Alicata, Daniel;Volkow, Nora
目的回顾使用甲基苯丙胺的个体以及产前暴露于甲基苯丙胺的儿童的大脑结构、化学和代谢变化，特别是基底神经节的变化。方法回顾和总结了核磁共振成像（MRI）和正电子发射断层扫描（PET）技术在评估甲基苯丙胺受试者或产前甲基苯丙胺暴露儿童脑结构、化学和代谢物变化方面的研究。相关的临床前研究为这些影像学研究的解释提供了见解。结果在使用甲基苯丙胺的成年人中，MRI显示纹状体体积增大，而MR光谱显示基底神经节中神经元标记物n -乙酰天冬氨酸和总肌酸浓度降低。相比之下，产前接触甲基苯丙胺的儿童纹状体结构较小，总肌酸升高。此外，PET研究一致显示，甲基苯丙胺受试者纹状体中多巴胺转运体（DAT）密度降低，多巴胺D-2受体减少。PET研究还发现纹状体亚区血清素能转运体密度和水泡状单胺转运体（VMAT2）水平较低，以及与边缘和眶额区精神症状严重程度相关的脑葡萄糖代谢改变。结论神经影像学研究令人信服地表明，使用甲基苯丙胺的个体和产前暴露于甲基苯丙胺的儿童的大脑结构和化学异常，尤其是纹状体。然而，许多重要的问题仍然存在，需要更大的样本量来验证这些初步观察结果。此外，需要进行纵向研究来评估治疗和戒断对这些大脑变化的影响，并确定是否可以使用影像学和可能的遗传标记来预测治疗结果或复发。
Aims To review structural, chemical and metabolic brain changes, particularly those in the basal ganglia, in individuals who used methamphetamine, as well as in children with prenatal methamphetamine exposure. Methods Magnetic resonance imaging (MRI) and positron emission tomography (PET) studies that evaluated brain structural, chemical and metabolite changes in methamphetamine subjects, or children with prenatal methamphetamine exposure, were reviewed and summarized. Relevant pre-clinical studies that provided insights to the interpretations of these imaging studies were also reviewed. Results In adults who used methamphetamine, MRI demonstrates enlarged striatal volumes, while MR spectroscopy shows reduced concentrations of the neuronal marker N-acetylasparate and total creatine in the basal ganglia. In contrast, children with prenatal methamphetamine exposure show smaller striatal structures and elevated total creatine. Furthermore, PET studies consistently showed reduced dopamine transporter (DAT) density and reduced dopamine D-2 receptors in the striatum of methamphetamine subjects. PET studies also found lower levels of serotonergic transporter density and vesicular monoamine transporter (VMAT2) across striatal subregions, as well as altered brain glucose metabolism that correlated with severity of psychiatric symptoms in the limbic and orbitofrontal regions. Conclusion Neuroimaging studies demonstrate abnormalities in brain structure and chemistry convincingly in individuals who used methamphetamine and in children with prenatal methamphetamine exposure, especially in the striatum. However, many important questions remain and larger sample sizes are needed to validate these preliminary observations. Furthermore, longitudinal studies are needed to evaluate the effects of treatment and abstinence on these brain changes and to determine whether imaging, and possibly genetic, markers can be used to predict treatment outcome or relapse.