I-123 IPT SPECT를 이용한 주의력결핍 과잉행동장애 아동에서의 methylphenidate 투여 전후의 기저 신경절 도파민 운반체 밀도 변화 측정

Abstract

Purpose:Attention deficit hyperactivity disorder (ADHD) has been known as psychiatric disorder in childhood associated with dopamine dysregulation. In present study, we investigated changes in dopamine transporter (DAT) density of the basal ganglias using I－123 N－(3－iodopropen－2－yl) －2－carbomethoxy －3beta－(4－chlorophenyl) tropane [I－123 IPT] SPECT in children with ADHD before and after methylphenidate treatment.

Materials and Method：Nine drug－naive children with ADHD and seven normal children were included in the study. We performed brain SPECT two hours after the intravenous administration of I－123 IPT and made both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of specific/nonspecific DAT binding ratios in the basal ganglia. All children with ADHD reperformed [123I]IPT SPECT after treatment with methylphenidate (0.7mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ratio of the basal ganglia were compared between before and after treatment methylphenidate. We investigated correlation between the change of ADHD symptom severity assessed with ADHD rating scale－IV and specific/nonspecific DAT binding ratio of basal ganglia.

Results：Children with ADHD had a significantly greater specific/nonspecific DAT binding ratio of the basal ganglia comparing to normal children (Right：z = 2.057, p = 0.041；Left：z = 2.096, p = 0.032). Under treatment with methylphenidate in all children with ADHD, specific/nonspecific DAT binding ratio of both basal ganglia decreased significantly greater than before treatment with methylphenidate (Right：t = 3.239, p = 0.018；Left：t = 3.133, p = 0.020). However, no significant correlation between the change of ADHD symptom severity scores and specific/nonspecific DAT binding ratio of the basal ganglia were found.

Conclusions：These findings support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.