Changes in brain glucose metabolism in cocaine dependence and withdrawal.
Changes in brain glucose metabolism in cocaine dependence and withdrawal.
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DOI：
10.1176/ajp.148.5.621
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发表时间：
1991-05
期刊：
影响因子：
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通讯作者：
N. Volkow;J. Fowler;A. Wolf;R. Hitzemann;S. Dewey;B. Bendriem;Robert Alpert;A. Hoff
中科院分区：
文献类型：
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作者：
N. Volkow;J. Fowler;A. Wolf;R. Hitzemann;S. Dewey;B. Bendriem;Robert Alpert;A. Hoff
目的 作者研究了与可卡因依赖和戒断相关的大脑功能变化，以提供有关导致无法控制的自我服用可卡因的过程的线索。方法 他们使用 [18F]-氟脱氧葡萄糖 (FDG) 和正电子发射断层扫描测量了 15 名诊断为可卡因滥用的门诊患者和 17 名正常对照受试者的区域脑代谢。其中 10 名患者在最后一次吸食可卡因后不到 1 周内接受了研究，5 名患者在戒断后 2-4 周内接受了研究。结果 与正常受试者相比，在可卡因戒断后 1 周内进行研究的患者，而非在可卡因戒断后 2-4 周内进行研究的患者，其整体大脑代谢水平以及基底神经节和眶额皮质的区域大脑代谢水平较高，这可能是由于大脑多巴胺活性较低的结果。可卡因戒断后的天数与眶额皮质和基底神经节的区域脑葡萄糖代谢之间也存在显着关系，可卡因渴望与代谢活动之间的相关性在前额皮质和眶额皮质中也显着。结论 虽然代谢活性随时间的下降表明可卡因戒断后不到一周观察到的较高代谢活性可能代表药物戒断的非特异性表达，但基底神经节和眶额皮质葡萄糖代谢变化的选择性表明可卡因滥用者在戒毒期间观察到的区域代谢变化与大脑多巴胺活性的变化有关。
OBJECTIVE The authors investigated changes in brain function associated with cocaine dependence and withdrawal to provide clues regarding the processes that lead to the uncontrollable self-administration of cocaine. METHOD They measured regional brain metabolism with [18F]-fluorodeoxyglucose (FDG) and positron emission tomography in 15 outpatients with the diagnosis of cocaine abuse and 17 normal comparison subjects. Ten of the patients were studied less than 1 week after they had last had cocaine, and five were studied 2-4 weeks after withdrawal. RESULTS Patients studied within 1 week of cocaine withdrawal but not those studied within 2-4 weeks of cocaine withdrawal had higher levels of global brain metabolism as well as higher levels of regional brain metabolism in the basal ganglia and orbitofrontal cortex than did normal subjects, probably as a consequence of less brain dopamine activity. There was also a significant relationship between the number of days since cocaine withdrawal and regional brain glucose metabolism in the orbitofrontal cortex and in the basal ganglia, and the correlations between cocaine craving and metabolic activity were significant in the prefrontal cortex and the orbitofrontal cortex. CONCLUSIONS Although the time-dependent fall in metabolic activity suggests that the higher metabolic activity observed less than a week after cocaine withdrawal may represent a nonspecific expression of drug withdrawal, the selectivity of changes in glucose metabolism for the basal ganglia and for the orbitofrontal cortex suggests that the regional metabolic changes seen in cocaine abusers during detoxification are related to changes in brain dopamine activity.