不同酒精代謝酶ALDH2基因型酒癮者之Tc-99m TRODAT-1腦造影：初報

背景：酒精成癮（alcoholic）是一種常見的精神疾患，許多亞洲人因其ALDH2基因位點突變，故對於酒精更具敏感性，更容易成癮。研究顯示：酒癮者的諸多臨床表現與其腦中多巴胺神經元（dopamine neuron）的活性關係密切，但相關的影像學研究卻相當罕見。方法：經PCR技術鑑定確定為ALDH2*1基因型酒癮者5例、ALDH2*2基因型酒癮者6例及非基因型酒癮者3例，共14例參與本研究，在獲病人同意並完成簽署後，對其執行可代表腦中多巴胺轉運體（dopamine transporter）密度的核醫Tc-99m TRODAT-1腦造影。結果：5例ALDH2*1基因型酒癮者之腦造影皆顯示兩側基底核無明顯增加或減少吸收造影劑，6例ALDH2*2基因型酒癮者之腦造影有1例呈現無明顯異常、4例呈現左或右側基底核、部份或全部減少吸收造影劑、另1例顯示兩側基底核彌漫性中度減少吸收造影劑，3例非基因型酒癮者之腦造影皆呈現左或右側基底核、部份或全部減少吸收造影劑。結論：不同ALDH2基因型與非基因型酒酒癮者腦中多巴胺轉運體密度亦不同，Tc-99m TRODAT-1腦造影或可作為酒癮者日後治療選擇及追蹤之用。

關鍵字

酒癮；多巴胺轉運體； Tc-99m TRODAT-1腦造影

並列摘要

Background: Alcoholic is a common psychiatric disorder. Many Asian are more sensitive to alcohol and easily become alcoholics for having point mutation on their ALDH2 gene. Investigations have shown a significant correlation between the clinical features of alcoholic and the activity of dopamine neurons in the brain, related brain imaging study, however, is very rare. Methods: A total of 14 patients were enrolled in this study including five ALDH2*1 and six ALDH2*2 mutation carriers, and three non-genotype alcoholics. All patients signed informed consents and underwent Tc-99m TRODAT-1 imaging, which indicates the dense of dopamine transporter and can be used to assess early dopaminergic neuron loss in the brain. Results: There was normal uptake TRODAT-1 in bilateral striatal regions in five ALDH2*1 and one ALDH2*2 alcoholics. Asymmetric striatal uptake with mild decrement in the right side or left side caudate and/or putamen was shown in four ALDH2*2 and three non-genotype alcoholics. The remaining one ALDH2*2 revealed diffusely decreased uptake in bilateral striatal regions. Conclusion: There are alternations of Tc-99m TRODAT-1 brain images in alcoholics with variant ALDH2 gene allele, and the imaging may be helpful for choosing the best therapeutic approach and proper follow-up in alcoholics.

並列關鍵字

alcoholic ； dopamine transporter ； and Tc-99m TRODAT-1 brain imaging

國際替代計量

不同酒精代謝酶ALDH2基因型酒癮者之Tc-99m TRODAT-1腦造影：初報

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