Erken ve geç başlangıçlı alkol bağımlılarında bölgesel beyin kan akımının değerlendirilmesi: SPECT çalışması

Öz

Amaç: Alkol bağımlılığının beynin yapısı ve işlevselliği üzerinde olumsuz etkileri vardır. Alkole başlangıç yaşı, alkol bağımlılarının gruplandırılmasında önemli bir parametredir. Bu çalışmanın amacı erken (EB) ve geç başlangıçlı (GB) alkol bağımlılarında bölgesel beyin kan akımı (b-BKA) değerlerlerinin farkılılık gösterip göstermediğini karşılaştırmaktır.

Yöntemler: DSM-IV ölçütlerine gore alkol bağımlılğı tanısı olan 33 erkek hasta ve 13 sağlıklı control çalışmaya alınmıştır. Kortikal serebral kan akımının bölgesel değerleri yüksek çözünürlüklü Tc-99m-HMPA tek foton emisyon bilgisayarlı tomografi kullanılarak değerlendirilmiştir. Alkolik olgular sorunlu alkol başlangıç yaşına göre iki gruba ayrılmıştır. 

Bulgular:  Üç grup karşılaştırıldığında alt frontal, alt temporal, alt sol oksipital ve orta sol frontal bölgelerde b-BKA farklılıkları saptanmıştır (p<0.05). GB grupta control grubuna göre her iki alt frontal ve temporal bölgede azalmış b-BKA değerleri bulunmuştur (p<0.005). GB grup EB grupla karşılaştırıldığında, alt frontal ve temporal, alt sol oksipital ve orta sol frontal bölgelerde anlamlı derecede azalmış b-BKA değerleri göstermiştir (p<0.05). 

Sonuç: Bulgularımız erken ayıklık dönemindeki EB ve GB alkol bağımlılarında b-BKA’nda farklılıklar olduğunu ortaya koymuştur. Bu bulgular daha önceki çalışmalarda da belirtildiği üzere frontal lobun alkolizmin nörobiyolojisinde kilit role sahip olduğuna işaret etmektedir. Uzun sureli ayıklık döneminden sonra ölçümlerin tekrarlanması alkol bağımlısı gruplar arasındaki farklılıkların ortaya konmasında yararlı olacaktır. 

Anahtar Kelimeler

• Alkolizm,SPECT,Serebral kan akımı

Assessment of regional cerebral blood flow in patients with early and late onset alcohol dependence: SPECT study

Abstract

Aim: Alcohol dependence has negative effects on the structure and functionality of the brain. The age of onset of alcohol is an important parameter in the grouping of alcoholics. The aim of this study is to compare whether regional cerebral blood flow (r-CBF) values differ between early (EO) versus late onset (LO) alcoholic patients.

Methods: A total of 33 male patients with alcohol dependence as per DSM-IV criteria and 13 healthy controls were enrolled for the study. Regional measures of cortical cerebral blood flow were assessed using a high resolution Tc-99m-HMPAO single photon emission computed tomography (SPECT). Alcoholic subjects were divided into two groups according to onset of problematic alcohol drinking age. 

Results: When three groups were compared, r-CBF differences were obtained in inferior frontal, inferior temporal, inferior left occipital and middle left frontal regions. Decreased r-CBF values were found in LO group when they compared to controls in both lower frontal and temporal regions (p<0.05). LO group showed significant reduced r-CBF values in regions of inferior frontal and temporal, inferior left occipital and middle left frontal when compared with EO. 

Conclusion: Our findings revealed that, there were differences in r-CBF values in EO and LO alcoholics at early abstinence period. These findings suggest that frontal lobes have a key role in alcoholism neurobiology, as noted in previous studies. Repeating the measurements after a long-term abstinence will be useful in revealing differences among the alcoholic groups. 

Keywords

• Alcoholism,SPECT,Cerebral blood flow

Kaynakça

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