Aplicaciones de las técnicas de neuroimagen en las conductas adictivas
DOI:
https://doi.org/10.20882/adicciones.650Palabras clave:
técnicas de neuroimagen, conductas adictivas, alcoholismo, resonancia magnética cerebral, tomografía por emisión de positrones (PET), tomografía por emisión de fotón simple (SPECT)Resumen
Las técnicas de neuroimagen facilitan tanto el estudio funcional y estructural del cerebro, como la evaluación de los efectos que sobre el mismo producen los psicofármacos y las sustancias psicoactivas.Las técnicas de imagen estructural, como la tomografía cerebral y la resonancia magnética estructural, han sido utilizadas para detectar cambios en el volumen tisular de la sustancia gris y blanca, tras el consumo excesivo y prolongado de alcohol, su relación con el envejecimiento y su reversibilidad con la abstinencia continuada.Las técnicas de imagen funcional (PET, SPECT, resonancia magnética funcional y espectroscópica), permiten relacionar la actividad de algunas regiones del cerebro con la conducta. Mediante la utilización de radiofármacos, o drogas marcadas con isótopos radiactivos, se puede obtener información sobre las alteraciones funcionales de la neurotransmisión, que subyacen a determinados fenómenos como el efecto reforzador, el “craving”, la tolerancia al alcohol, la abstinencia, etc.Las nuevas técnicas de neuroimagen podrían aportar un mayor conocimiento sobre los circuítos neuro-anatómicos y neuro-químicos, que modulan los efectos emocionales, cognitivos, motivacionales y reforzadores de las sustancias psicotrópicas. Todo ello podría resultar decisivo para el desarrollo de las neurociencias y también de una nueva farmacoterapia para las conductas adictivas.Citas
Abi-Dargham A; Krystal Jh; Anjilvel S; Scanley Be; Zoghbi S; Baldwin Rm; Rajeevan N; Ellis S; Petrakis Il; Sebyl Jp; Charney Ds; Laruelle M; Innis Rb: (1998) Alterations in benzodiazepine receptors in tipe II alcoholic subjects measured with SPECT and [123I] Iomazenil. Am. J. Psychiatry 155: 1550-1555.
Agartz I; Momenam R; Rawlings RR; Kerich MJ; Hommer DW.: (1999) Hippocampal volume in patients with alcohol dependence. Arch. Gen. Psychiatry 56:356- 336.
Behar KL; Rothman DL; Petersen KF; Hooten M; Delaney R; Petroff O; Shulman GI; Navarro V; Petrakis IL; Charney DS; Krystal JH: (1999) Preliminary evidence of low cortical GABA levels in localized 1H-MR spectra of alcohol-dependent and hepatic encephalopathy patients. Am. J. Psychiatry 156:925-954.
Breiter HC; Rauch SL; Kwong KK; Baker JR;Weisskoff RM; Kennedy DN; Kendrick AD; Davis AD; Jiang A; Cohen MS; Stern CE; Belliveau JW; Baer L; O’Sullivan RL; Savage CR; Jenicke MA; Rosen BR: (1996) Functional margentic resonance imaging of symptom provocation in obsessive-compulsive disorder.Arch. Gen. Psychiatry. 53:595-606.
Brücke T; Podreta I; Angelberer P;Wenger S;Topitz A; Küfferle B; Müller Ch; Deecke L: (1991) Dopamine D2 receptor imaging with SPECT studies in different neuropsychiatric disorders.J. Cereb. Blood Flow Metab. 11:220-228.
Catafau AM: (1998) Spect cerebral de neurorreceptores: el estudio in vivo de la acción central de los antipsicóticos. Revisiones en Psicofarmacología 2:7-13.
Catafau AM; Etcheberrigaray A; Perez de los Cobos J; Estorch M; Guardia J; Flotats A; Bernà L; Marí C; Casas M; Carrió I: (1999) Regional cerebral blood flow changes in chronic alcoholic patients induced by naltrexonae challenge during detoxification. J. Nucl. Med. 40:19-24.
Childress AR; Mozley PD; McElgin W; Fitzgerald J; Reivich M; O’Brien CP: (1999) Limbic activation during cue-induced cocaine craving. Am. J. Psychiatry 256:11-18.
Emsley R; Smith R; Roberts M; Kapnias M; Pieters H; Maritz S.: (1996) Magnetic resonance imaging in alcoholic Korsakoff’s syndrome: evidence for an association with alcoholic dementia. Alcohol Alcohol. 31:479-486.
Ferracci F; Conte F; Gentile M; Candeago R, Foscolo L; Bendini M; Fassetta G.: (1999) Computed tomographic scan 99mTc HMPAO-SPECT, and FLAIR MRI findings in a patient with subcortical aphasia, alexia, bilateral agraphia, and left-handed deficit of constructional ability. Arch. Neurol. 56:107-110.
Fowler JS;Volkow ND; Malison R; Gatley SJ: Neuroimaging studies of substance abuse disorders. In: Charney DS; Nestler EJ; Bunney BS (Eds.) Neurobiology of mental illness. New York. Oxford University Press, 1999 (p. 616-626)
Guardia Serecigni J; Freixa F; Bach L; Ruscalleda J; M. dos Santos F; Guardia E; Carvajal A: (1982) Valoración de diferentes parámetros de normalidad mediante estudios con Tomografía Computarizada Cerebral. Rev. Dep. Psiquiatría Fac. Med. Barcelona. 9:335-350.
Guardia, J.: (1985) Estudio de un grupo de alcohólicos de larga evolución, con signos menores de encefalopatía. Rev. Dep. Psiquiatría Fac. Med. Barcelona. 12:331- 347.
Guardia Serecigni J; Prat Vigué G: (1997) Psicobiología del alcoholismo. Medicina del Trabajo 6:287-305.
Guardia Serecigni J; Prat Vigué G; Casas Brugué M: (1998) El sistema opioide como modulador del consumo de alcohol. Psiqquiatría Biológica 5:25-34.
Guardia J; Catafau AM; Batlle F; Martían JC; Segura L; Gonzalvo B; Prat G; Carrió I; Casas M: (2000) Striatal dopaminergic D2 receptor density measured by [123I] Iodobenzamide SPECT in the prediction of treatment outcome of alcohool-dependent patients. AM. J. Psychiatry 157.
Guettat L; Guille M; Delbecq J; Depre A.: (1997) Folic acid deficiency with leukoencephalopathy and chronic axonal neuropathy of sensory predominance. Rev. Neurol. (Paris) 153:351-353.
Heinz A; Highley JD; Gorey JG; Saunders RC; Jones DW; Hommer D; Zajiecek K; Suomi SJ; Lesch KP; Weinberger DR; Linnoila M: (1998a) In vivo associatio between alcohol intoxication, agression and serotonin trasnporter abailability in nonhuman primates. Am. J. Psychiatry 155:1023-1028.
Heinz A; Ragan P; Jones DW; Hommer D;Williams W; Knable MB; Gorey JG; Doty L; Geyer C; Lee KS; Coppola R; Weinberger DR; Linnoila M: (1998b) Reduced central serotonin transporters in alcoholism. Am. J. Psychiatry 155:1544-1549.
Hietala J,West C, Syvälahti E, Nagren K, Lhikoinen P, Sonninen P, Ruotsalainen U: (1994) Striatal D2 dopamine receptor binding characteristics in vivo in patients with alcohol dependence. Psychopharmacology; 116:285-290.
Holcomb HH; Cascella NG; Thaker GK; Medoff DR; Dannals RF; Tamminga CA: (1996) Functional sites neuroleptic drug action in the human brain: PET/FDG studies with and without haloperidol. Am. J. Psychiatry. 153:41-49.
Iwata N; Cowley DS; Radel M; Roy-Byrne PP; Goldman D: (1999) Relation between a GABA A a6 Prro385Ser substitution and benzodiazepine seusitivity. Am. J. Psychiatry 156:1447-1449.
Jenike MA; Rauch SL; Cummings JL; Savage CR; Goodman WK: (1996) Recent developments in neurobiology of absessive-compulsive disorder J. Clin. Psychiatry 57:492-503.
Johnson DL; Wiebe JS; Gold SM; Andreasen NC; Hichwa RD;Watkins GL; Ponto LLB: (1999) Cerebral blood flow and personality: a positron emission tomgrphy study. Am. J. Psychiatry 156:252-2576.
Kaplan HI; Sadock BJ; Grebb JA: Sinopsis de Psiquiatría. Séptima edición. Editorial Panamericana. Buenos Aires. 1996 (p. 118-128).
Kosten TR; Cheeves C; Palumbo J; Seibyl JP; Price LH;Woods SW: (1998)Regional cerebral blood flow during acute and chronic abstinence from combined cocaine-alcohol abuse. Drug and Alcohol Dependence 50: 187-195.
Kung HF, Alavi A, Chang W, Kung M-P, Keyes JW Jr, Velchick MG, Billings J, Pan S, Noto R, Rausch A, Reilley J: (1990) In vivo SPECT imaging of CNS D-2 dopamine receptors: Initial studies with Iodine-123- IBZM in humans. J Nucl Med.; 31:573-579.
Laruelle M; Abi-Dargham A; van Dyck CH; Rosenblatt W; Zea-Ponce Y; Zoghbi SS; Baldwin RM; Charney DS; Hoffer PB; Kung HF; Innis R: (1995) SPECT ima- ging of striatal dopamine release aftrer amphetamine challenge. J. Nucl. Med. 36:1182-1190.
Lingford-Hughes AR;Acton PD; Gacinovic S; Suckling J; Busatto GF; Boddington SJA; Bullmore E;Woodruff PW; Costa DC; Pillowsky LS; Ell PJ; Marshall EJ; Kerwin RW: (1998) Reduced levels of GABA-benzodiazepine receptor in alcohol dependencW in the asence of grey matter atrophy. Br. J. Psychiatry 173:116-122.
Litton Je; Neiman J; Pauli S, Farde L; Hindmarsh T; Halldin C, Sedvall G: (1993) PET analysis of [11 C] flumazenil binding to benzodiazepine receptors in chronic alcohol-depndent men and healthy controls. Psych. Res. 1-13.
Lomeña F; Catafau AM: (1995) SPECT cerebral. JANO 49:1634-1636.
Malison RT; Mc Dougle CJ; van Dyck CH; Scahill L; Baldwin RM; Seibyl JP; Price LH; Leckman JF; Innis RB: (1995) [123I] ß-CIT SPECT Imaging of striatal dopamine transporter binding in Tourette’s disorder. Am. J. Psichiatry 152:1359-1361.
Malison RT; Best SE; van Dyck CH; McCance EF, Wallace EA; Laruelle M; Baldwin RM; Seibyl JP; Price LH; Kosten TR; Innis RB: (1998) Elevated striatal dopamine transporters during acute cocaine abstinence as measured by [123I] b-CIT SPECT. Am. J. Psychiatry 155:832-834.
Matsuda K;Yamaji S; Ishii K; Sasaki M; Sakamoto S; Kitagaki H; Imamura T; Mori E.: (1997) Regional cerebral blood flow and oxygen metabolism in a patient with korsakoff syndrome. Ann. Nucl. Med. 11:33-35.
Mayberg HS; Liotti M; Brannan SK; McGinnis S; Mahurin RK; Jerabek PA; Silva JA;Tekell JL; Martin CC; Lancaster JL; Fox PT: (1999) Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness. Am. J. Psychiatry 156:675-682.
Miller RF; Harrison MJ; Hall-Craggs MA; Scaravilli F.: (1998) Central pontine myelinolysis in AIDS. Acta Neuropathol. (Berl) 96:537-540.
Modell JG; Moutz JM: (1995) Focal cerebral blood flow change during craving for alcohol measured by SPECT. Journal of Neuropsychiatry and Clinical Neurosciences 7:15-22.
Neiman J: (1998) Alcohol as a risk factor for brain damage: neurologic aspects. Alcohol. Cli. Exp. Res. 22: 346S-351S.
Nicolás JM; Catafau AM; Estruch R; Lomeña FJ; Salamero M; Herranz R; Monforte R; Cardenal C; Urbano- Marquez A.: (1993) Regional cerebral blood flow- SPECT in chronic alcoholism: relation to neuropsychological testing. J. Nucl. Medecine 34:1452-1459.
Salonen I; Hietala J; Laihinen A; Lehikoinen P; Leino L; Nagren K; Ruotsalainen U; Oikonen V;Tuokkola T; Näntö V: (1997) A PET study on the acute effect of ethanol on striatal D” dopamine receptors with [11C] raclopride in healthy males. Human pasychopharmacology 12: 145-152.
Saxena S; Brody AL; Schwartz JM; Baxter LR: (1998) Neuroimaging and frontal-subcortical circuitry in obsessive- compulsive disorder. Br. J. Psychiatry 173:(suppl 35), 26-37.
Schuckit MA; Smith Tl: (1996) An 8-year follow-up of 450 sons of alcoholic and control subjects. Arch. Gen. Psychiatry 53:202-210.
Schuckit MA; Mazzanti C; Smith Tl; Ahmed U; Radel M; Iwata N; Goldman D: (1999) Selective genotyping for the role o 5-HT2A, 5-HT2C, and GABA alpha 6 receptors and the serotonin transporter in the level of response to alcohol: a pilot study. Biol. Psychiatry 45:647-651.
Seibyl JP; Scanley E; Krystal JH; Innis RB: Neuroimaging methodologies. In: Charney DS; Nestler EJ; Bunney BS (Eds.) Neurobiology of mental illness. New York. Oxford University Press, 1999 (p. 170-189).
Seitz D; Widmann U; Seeger U; Nägele T; Klose U; Mann k, Grodd W.: (1999) Localized proton magnetic resonance spectroscopy of the cerebellum in detoxifying alcoholics. Alcoholism Clin. Exp. Res. 23:158- 163.
Smith KA; Morris JS; FristonKJ; Cowen PJ; Dolan RJ: (1999)Brain mechanisms associated with depressive relapse and associated cognitive impairment following acute tryptophan depletion. Br. J. Psychiatry 174:525- 529.
Stein EA; Pankiewicz J; Harsch HH; Cho JK; Fuller SA; Hoffmann RG; Hawkins M; Rao SM; Bandettini PA; Bloom AS.: (1998) Nicotine-induced limbic cortical activation in the human brain: a functinal MRI study. Am. J. Psychiatry 155:1009-1015.
Tiihonen J, Huikka J, Bergström K, Hakola P, Karhu J, Ryynänen OP, Föhr J: (1995) Altered striatal dopamine re-uptake site densities in habitually violent and nonviolent alcoholics. Nature Medicine 1:654-657.
Verhoeff NP, Kapucu O, Sokole-Busemann E, Van Royen EA, Janssen AG: (1993) Estimation of dopamine D2 receptor binding potential in the striatum with iodine-123-IBZM SPECT: Technical and interobserver variability. J. Nucl. Med.34:2076-2084.
Volkow ND; Fowler JS;Wolf AP; Hitzemann R; Dewey S; Alpert R; Hoff A: (1991) Changes in brain glucose metabolism in cocine dependece and withdrawal. Am. J. Psychiatry 148:621-626.
Volkow ND; ; Fowler JS; Wang GJ; Hitzemann R; Logan J;Schlyer D; Dewey S; Wolf AP: (1993a) Decreased dopamine D2 receptor availability is associated with reduced frontal metabolism in cocaine abusers. Synapse 14: 169-177.
Volkow ND;Wang GJ; Hitzemann R; Fowler JS;Wolf AP; Pappas N; Bigeon A; Dewey SL: (1993b) Decreased cerebral response to inhibitory neurotransmission in alcoholics. Am. J. Psichiatry. 150:417-422.
Volkow ND;Wang GJ; Hitzemann R; Fowler JS; Overall JE; burr G;Wolf AP: (1994) Recovery of brain glu- cose metabolism in detoxified alcoholics. Am. J. Psychiatry 151:178-183.
Volkow ND;Wang GJ; Begleiter H; Hitzemann R; Pappas N; Burr G; Pascani K;Wong C; Fowler JS;Wolf A: (1995a) Regional brain metabolic response to lorazepam in subjects at risk for alcoholism. Alcoholism Clin. Exp. Res. 19:510-516.
Volkow ND; Ding YS; Fowler JS;Wang GJ; Logan J; Gatley JS; Dewey S; Ashby C; Liebermann J; Hitzemann R; Wolf AP: (1995b) Is Methylphenidate like cocaine? Am. J. Psychiatry 52: 456-463.
Volkow ND,Wang GJ, Fowler JS, Logan J, Hitzemann R, Ding YS, Pappas N, Shea C, Piscani K: (1996a) Decreases in dopamine receptors but not in dopamine transporters in alcoholics. Alcoholism: Clinical & Experimental Research; 20:1594-1598.
Volkow ND;Wang GJ; Fowler JS; Gatley SJ; Logan J; Dewey SL; Hitzemann R; Lieberman J: (1996b) Relationship between psychostimulant-induced “high” and dopamine transporter occupancy. Proc. Nat.Acad. Sci. USA 93: 10388-10392.
Volkow ND; Ding Y-S; Fowler JS;Wang GJ: (1996c) Cocaine addiction: hypothesis derived from imaging studies with PET. J.Addict. Dis 15:55-71.
Volkow ND;Wang GJ; Fowler JS; Hitzemann R; Pappas N; Pascani K;Wong C: (1997a) Gender differences in cerebellar metabolism: test-retest reproductibility. Am. J. Psychiatry 154: 119-121.
Volkow ND; Wang GJ; Fischman MW; Foltin RW; Fowler JS;Abumrad JS;Vitkun NN; Logan J; Gatley SJ; Pappas N; Hitzemann R; Shea K: (1997b) Relationship between subjective effects of cocaine and dopamine transporter occupancy. Nature 386: 827- 830.
Volkow Nd;Wang Gj; Overall Je; Hitzemann R; Fowler JS; Pappas N; Frecska E; Piscani K: (1997c) Regional brain metabolic response to lorazepam in alcoholics during early and late alcohol detoxification. Alcohol. Clin. Exp. Res. 21:1278-1284.
Volkow ND, Gur RC,Wang GJ, Fowler JS, Moberg PJ, Ding YS, Hitzemann R, Smith G, Logan J: (1998) Association between decline in brain dopamine activity with age and cognitive and motor impairment in healthy individuals. Am. J. Psychiatry; 155:344-349.
Volkow ND,Wang GJ, Fowler JS, Logan J; Gatley SJ; Gifford A; Hitzemann R; Ding YS; Pappas N: (1999a) Prediction of reinforcing responses to psychostimulants in humans by brain dopamine D2 receptors levels. Am. J. Psychiatry. 156:1440-1443.
Volkow ND, Wang GJ, Fowler JS, Hitzemann R, Angrist B; Gatley SJ; Logan J; Ding YS; Pappas N: (1999b) Association of methylphenidate-induced craving with changes in right striato-orbitofrontal metabolism in cocine abusers: implications in addiction. Am. J. Psychiatry 156:19-26.
