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Alterations of regional cerebral blood flow after NMDA receptor antagonist administration in patients with alcohol-related dementia

机译:酒精相关痴呆患者服用NMDA受体拮抗剂后局部脑血流的变化

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Although N-methyl-d-aspartate (NMDA) receptor antagonists may have beneficial influences on cognition in patients with alcohol-related dementia (ARD), their effects on regional cerebral blood flow (rCBF) remain unknown. This study evaluated changes in rCBF in ARD patients after administration of NMDA receptor antagonist for 12weeks using technetium-99m ethyl cysteinate dimer (Tc-99m ECD) single-photon emission computed tomography (SPECT). Twenty-eight ARD patients were administered memantine for 12weeks and underwent clinical evaluations and brain SPECT scans at baseline and follow-up. Whole-brain changes in perfusion were examined on a voxel-by-voxel basis. At follow-up, the patients showed reduced rCBF in the left medial frontal gyrus, left cingulate gyrus, left claustrum, right brainstem, left superior temporal gyrus, bilateral fusiform gyrus, and left cerebellum. On the other hand, increased rCBF was found in the bilateral uncus, left parahippocampal gyrus, bilateral superior frontal gyrus, right inferior parietal lobule, left cuneus, and left superior temporal gyrus. Perfusion increases in various brain areas including the superior frontal, parahippocampal, and inferior parietal areas, which may play important roles in the pathophysiology of ARD, suggest potential benefits of NMDA receptor antagonists on brain functions in patients with ARD.
机译:尽管N-甲基-d-天冬氨酸(NMDA)受体拮抗剂可能对酒精相关性痴呆(ARD)患者的认知产生有益的影响,但它们对局部脑血流量(rCBF)的影响仍然未知。这项研究使用tech 99m半胱氨酸乙酯二聚体(Tc-99m ECD)单光子发射计算机断层扫描(SPECT)评估了NMDA受体拮抗剂给药12周后ARD患者的rCBF的变化。 28名ARD患者接受美金刚治疗12周,并在基线和随访时进行了临床评估和脑SPECT扫描。在逐个体素的基础上检查全脑灌注的变化。在随访中,患者的左内侧额叶回,左扣带状回,左锁骨,右脑干,左颞上回,双侧梭状回和左小脑的rCBF降低。另一方面,在双侧un骨,左海马旁回,双侧额额上回,右顶壁小叶,左楔骨和左颞上回中发现rCBF增加。在各种大脑区域(包括上额叶,海马旁和下顶叶区域)的灌注增加,这可能在ARD的病理生理中起重要作用,提示NMDA受体拮抗剂对ARD患者的脑功能有潜在的好处。

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