Evaluation of Striatal Dopamine Transporter Density using $[^{123}I]-{\beta}-CIT$ SPECT in Schizophrenic Patients Treated with Olanzapine: Pilot study

정신분열병 환자에서 Olanzapine 사용 전후의 $[^{123}I]-{\beta}-CIT$ SPECT를 이용한 Dopamine Transporter 변화: 준비조사

  • 김철응 (인하대학교 의과대학 정신과학교실) ;
  • 문혜원 (인하대학교 의과대학 정신과학교실) ;
  • 최원식 (인하대학교 의과대학 핵의학과) ;
  • 김창호 (인하대학교 의과대학 핵의학과) ;
  • 지대윤 (인하대학교 의과대학 화학과)
  • Published : 2002.08.30

Abstract

Purpose: This pilot study was performed to understand the pharmacological effect of olanzapine, an atypical antipsychotic agent, on dopamine transporter in schizophrenic patients. Materials and Methods: Six patients (3 male, 3 female) with schizophrenia, who had not taken any psychotropic drugs for at least four weeks, were studied. Nuclear imaging using $[^{123}I]-{\beta}-CIT$ SPECT was obtained before and after 4-week treatment with olanzapine. Analysis of ROI on the striatum, caudate nucleus, and putamen was performed. Results: Post-treatment uptake was significantly increased in all the ROIs compared with pre-treatment uptake. Conclusion: This preliminary study with the small number of schizophrenic patients suggested an increase in uptake of dopamine transporter in the striatum, caudate nucleus, and putamen after 4-week treatment with olanzapine, which warrants a large-scaled controlled study to confirm the current findings.

목적: 정신분열병의 병태생리와 이미 임상적인 효과와 안전성이 확인된 비정형항정신병약물의 하나인 올란자핀의 작용기전 중 도파민전달체에 대한 효과를 구명하고자 본 연구를 고안했다. 대상 및 방법: 최소 4주 이상 항정신병약물을 사용하지 않았고 DSM-IV진단기준을 만족시키는 정신분열병 환자 6명(남 3, 여 3)에게 본 연구의 목적을 설명한 후 동의를 얻고 올란자핀 사용 전, 사용 4주 후 2회 $[^{123}I]-{\beta}-CIT$ SPECT영상을 얻었다. 얻은 영상에서 선조체/후두엽 비율을 측정했고 미상/피각으로 나누어 약물 사용 전 후를 비교분석 했다. 결과: 선조체 및 미상/피각 전부위의 $[^{123}I]-{\beta}-CIT$ 결합율은 올란자핀 사용 4주후 사용 전에 비해 의미있는 증가를 보였다(p<0.05). 결론: 본 연구결과는 올란자핀이 도파민전달계 중 도파민 운반체에 변화를 보임을 시사하고 있으나 확증을 위해서는 더 많은 환자와 정상인을 대상으로 한 비교 연구가 필요하다고 생각된다.

Keywords

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