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[123I]-Iomazenil SPECT를 이용한 공황장애 환자에서 대뇌 벤조다이아제핀 수용체 결합 이상

Abnormal Cerebral Benzodiazepine Receptors Binding Measured with [123I]-Iomazenil SPECT in Panic Disorder

김영기|박경민|이상민|김찬형|노대영|류영훈
대한신경정신의학회 (Korean Neuropsychiatric Association)|2010.03|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제49권 제2호|pp. 235-240

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키워드

공황장애·[123l]-lomazenil SPECT·벤조다이아제핀 수용체.Panic disorder·[123I]-Iomazenil SPECT·Benzodiazepine receptor.
주제분류정신과학

초록

이번 연구는 국내에서 공황장애 환자를 대상으로 BZDGABA계의이상을 처음으로 직접 확인하였다는 데에 큰 의의가 있을 것으로 생각된다. 정상인과 비교했을 때, 공황장애환자에서 벤조다이아제핀 수용체 결합이 뇌의 영역에 따라차이(증가 혹은 감소)가 나타난 것은 BZD-GABA계 이상이공황장애의 병태생리와 연관될 가능성을 시사한다. 공황장애의 병태생리를 이해하기 위해서는 향후 좀 더 많은 환자군을 대상으로 치료적 개입 및 임상 증상의 변화에 따른 추적연구가 도움이 될 것이다. 또한 PET와 같이 보다 높은 해상도의 다른 영상학적 연구 방법을 이용하여 병태생리에 관여하는 신경해부학적 영역을 확인할 필요가 있겠다.

Abstract

Objectives: Researchers have long hypothesized that the benzodiazepine-GABA system plays a role in the pathophysiology of panic disorder (PD). However, previous neuroimaging studies have been inconclusive, possibly due to matching discrepancies between patients and controls,confounding medication factors, and/or image analyzing methods. This study aimed to compare benzodiazepine receptor binding between PD patients and healthy controls. Methods: Via 123I-iomazenil single-photon emission computed tomography (IMZ-SPECT), we obtained regional brain patterns of benzodiazepine receptor binding for 12 unmedicated PD patients and 8 healthy age-and sex-matched volunteer controls. To analyze the image data, we used statistical parametric mapping (SPM). Results: Benzodiazepine receptor binding showed a decrease in both the parietal and occipital lobes in PD patients as compared to controls. The anterior cingulate cortex, left parahippocampal gyrus, and both temporal lobes showed increased binding in PD patients. Conclusion: Our findings provide evidence of an abnormal BZD-GABA system in PD patients,suggesting that basal and/or compensatory changes in inhibitory neurotransmissions contribute to the pathogenesis of human PD.

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