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DOI：
10.1176/ajp.150.3.417
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发表时间：
1993-03
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目的：γ-氨基丁酸（GABA）-苯二氮卓受体功能的改变与酒精耐受、戒断和依赖有关。本研究的目的是调查是否最近脱毒酒精受试者有脑GABA-苯二氮卓受体功能异常。方法应用正电子发射断层扫描（PET）和[18F]氟代脱氧葡萄糖（FDG）技术，观察了12例正常人和10例酒精中毒者服用30 μ g/kg劳拉西泮后局部脑葡萄糖代谢的变化。结果劳拉西泮可降低正常人和酒精中毒者全脑葡萄糖代谢（分别降低13%和10%），且降低程度与血浆中劳拉西泮浓度相关。而正常和酗酒的受试者表现出类似的反应，劳拉西泮在枕叶和小脑代谢，酗酒的受试者表现出显着低于比较受试者在丘脑，基底神经节，眶额皮质的反应。基线时，眶额皮质的反应率与小脑代谢显著相关。结论：酗酒者对劳拉西泮的反应迟钝，这是特定的大脑区域。小脑代谢和劳拉西泮反应之间的关联表明，小脑可能有助于降低劳拉西泮的敏感性，这是在酗酒的受试者。
OBJECTIVE Changes in gamma-aminobutyric acid (GABA)-benzodiazepine receptor function have been implicated in alcohol tolerance, withdrawal, and dependence. The purpose of this study was to investigate whether recently detoxified alcoholic subjects had abnormalities in brain GABA-benzodiazepine receptor function. METHOD The effect of 30 micrograms/kg of lorazepam on regional brain glucose metabolism was studied in 12 normal subjects and 10 alcoholic subjects with the use of positron emission tomography and [18F]fluorodeoxyglucose. RESULTS Lorazepam decreased whole brain glucose metabolism in both the normal subjects (13% change) and the alcoholic subjects (10% change), and the response was correlated with the concentration of lorazepam in plasma. Whereas the normal and alcoholic subjects showed similar responses to lorazepam in occipital and cerebellar metabolism, the alcoholic subjects showed significantly less of a response than the comparison subjects in the thalamus, basal ganglia, and orbitofrontal cortex. The rate of response in the orbitofrontal cortex was significantly correlated with cerebellar metabolism at baseline. CONCLUSIONS The alcoholic subjects had a blunted response to lorazepam that was specific to certain brain regions. The association between cerebellar metabolism and response to lorazepam suggests that the cerebellum may contribute to the decreased sensitivity to lorazepam which was seen in the alcoholic subjects.