Suchttherapie 2011; 12 - PO10
DOI: 10.1055/s-0031-1284660

[18F]Fallypride PET measurement of striatal and extrastriatal dopamine D2/3 receptor availability in patients with alcohol use disorder

G Koller 1, A Rominger 2, C La Fougere 2, M Soyka 3, P Cumming 2, P Bartenstein 2, O Pogarell 1
  • 1Klinik für Psychiatrie und Psychotherapie der LMU München
  • 2Nuklearmedizin, München
  • 3Privatklinik Meiringen, Meiringen, Schweiz

Aim: Dopaminergic pathways are implicated in motivational aspects of substance use disorders. Molecular imaging with positron emission tomography (PET) revealed reductions in the availability of binding sites for D2/3 receptor ligands in striatum of withdrawn abusers of cocaine; corresponding results in alcoholics have been inconsistent so far. In the present study, we used the D2/3ligand [18F]fallypride to investigate dynamic changes in receptor availability in the striatum of patients with alcohol use disorder before and after undergoing a detoxification protocol.

Methods: 17 male patients (mean age 44±5y) with alcohol use disorder were recruited and scanned with 180MBq [18F]fallypride upon hospital admission, and again one to two weeks later after detoxification. Four patients with long term abstinence or substantial harm reduction were rescanned at one year. The control group consisted of 14 age-matched healthy volunteers. Dynamic PET recordings (180 min) were used for VOI-based and voxel-wise analyses of striatal and extrastriatal [18F]fallypride binding potential (BPND).

Results: In patients mean BPND in whole striatum was 15.7±3.6 at baseline, not significantly different from healthy controls (16.8±3.0), but lower in thalamus, hippocampus, insular and temporal cortex (p<0.05). There were inverse correlations of BPND with age (r–0.45) and daily alcohol consumption (r–0.2). The age-dependence of BPND was more pronounced in the patient group. BPND was unaltered at short term follow-up, but increased by 30% in subjects with one year follow up.

Conclusions: VOI-based PET analyses revealed extrastriatal group differences in D2/3 receptor availability. BPND increased in the subgroup of patients with long term follow up, suggesting reversibility of receptor abnormalities. Regressions with age suggest an accelerated loss of dopamine D2/3 receptors in the striatum of subjects with alcohol use disorder.

[18F]Fallypride PET measurement - alcohol use disorder - dopamine D2/3 receptor