Untersuchungen zum Einfluß von »Ecstasy« auf den zerebralen Glukosemetabolismus: eine 18-FDG-PET-Studie

Zusammenfassung

Ziel: In der vorliegenden Studie sollte die Akutwirkung des »Ecstasy«- Analogons MDE (3,4-Methylendioxyethamphetamin) auf den zerebralen Glukosemetabolismus (rMRGIu) gesunder Probanden untersucht werden. Methode: In einer randomisierten Doppelblindstudie wurden 16 gesunde Probanden ohne Drogenanamnese mittels 18-FDG-PET 110-120 min nach oraler Verabreichung von 2 mg/kg KG MDE (n = 8) oder Plazebo (n = 8) untersucht. Zwei Minuten vor Injektion des Radio- pharmazeutikums startend erfolgte über insgesamt 32 min eine konstante kognitive Stimulation über ein Wortrepetitionsparadigma, um konstante und vergleichbare mentale Bedingungen während der zerebralen 18-FDG-Aufnahme zu gewährleisten. Die Darstellung der Indivi- dualanatomie erfolgte anhand T1-gewichteter 3D-flash MRT mit anschließender manueller Regionalisierung in 108 Regions-of-Interest und PET/MRT Overlay. Absolute Quantifizierung der rMRGIu sowie Normierung auf den Globalmetabolismus mit anschließendem Vergleich MDE versus Plazebo mittels U-Test nach Mann und Whitney. Ergebnisse: Gegenüber der Plazebo-Gruppe fand sich unter MIDE keine signifikante Änderung der globalen MRGIu (MDE: 41,8± 11,1 μmol/min/100 g, Placebo: 50,1 ± 18,1 μmol/min/100 g, p = 0,298). Die normierten metabolischen Daten zeigten eine signifikante Minderung der rMRGIu im beidseitigen Frontalkortex: links frontal posterior (-7,1%, p <0,05) und rechts präfrontal superior (-4,6 %, p <0,05). Signifikante Steigerungen der rMIRGIu fanden sich dagegen im beidseitigen Zerebellum (rechts: + 10,1%, p <0,01; links: +7,6 %, p <0,05) sowie im rechten Putamen (+6,2%, p <0,05). Schlußfolgerung: In der vorliegenden Studie konnten unter dem Akuteinfluß des »Ecstasy«-Analogons MDE neuro- metabolische Veränderungen im Sinne einer fronto-striato-cerebellären Dysbalance nachgewiesen werden, die Parallelen zu sowohl anderen psychotropen Substanzen als auch verschiedenen endogenen Psychosen aufweisen.

Summary

Purpose: The aim of the present study was to determine the acute effects of the “Ecstasy” analogue MDE (3, 4-methylendioxyethampheta- mine) on the cerebral glucose metabolism (rMRGIu) of healthy volunteers. Method: In a randomised double-blind trial, 16 healthy volunteers without a history of drug abuse were examined with 18-FDG PET 11ΟΙ 20 minutes after oral administration of 2 mg/kg MIDE (n = 8) or placebo (n = 8). Beginning two minutes prior to radiotracer injection, a constant cognitive stimulation was maintained for 32 minutes using a word repetition paradigm in order to ensure constant and comparable mental conditions during cerebral 18-FDG uptake. Individual brain anatomy was represented using T1-weighted 3D flash MRI, followed by manual régionalisation into 108 regions-of-interest and PET/MRI overlay. Absolute quantification of rMRGIu and comparison of glucose metabolism under MDE versus placebo were performed using Mann-Whitney U-test. Results: Absolute global MIRGIu was not significantly changed under MDE versus placebo (MDE: 41,8 ± 11,1 μmol/min/100 g, placebo: 50,1 ± 18,1 μmol/min/100 g, p = 0,298). The normalised regional metabolic data showed a significantly decreased rMRGIu in the bilateral frontal cortex: left frontal posterior (-7.1 %, p <0.05) and right prefrontal superior (-4.6%, p <0.05). On the other hand, rMRGIu was significantly increased in the bilateral cerebellum (right: +10.1 %, p <0.05; left: +7.6%, p <0.05) and in the right putamen (+6.2%, p <0.05). Conclusions: The present study revealed acute neurometabolic changes under the “Ecstasy” analogon MDE indicating a fronto-striato-cerebellar dysbalance with parallels to other psychotropic substances and various endogenous psychoses respectively.

Schlüsselwörter

»Ecstasy« - Entaktogene - Experimentalpsychose - Normierung - 18-FDG - PET

Keywords

“Ecstasy” - entactogens - experimental psychosis - normalisation - 18- FDG - PET

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