Bildgebende Diagnostik des zentralen serotonergen Systems: Aktueller Stand und Bedeutung für die neuropsychiatrische Forschung

Zusammenfassung

Das serotonerge System spielt eine wichtige, modulierende Rolle bei einer Vielzahl zentralnervös gesteuerter Funktionen. Eine Beeinträchtigung der zentralen Serotoninaktivität wird insbesondere bei neuropsychiatrischen Störungen als pathophysiologisch und pathogenetisch wichtiger Faktor diskutiert. Eine qualitative und quantitative bildgebende Darstellung dieses Neurotransmittersystems ist daher von wissenschaftlichem, zukünftig möglicherweise auch von klinischem Interesse. Die gezielte Darstellung serotonerger Strukturen mit PET oder SPECT wird allerdings durch die komplexe Neuroanatomie und methodisch bedingte Probleme erschwert. Bislang sind PET- und SPECT-Radioliganden für Serotonin-5HT_1A-/5HT_2A-Rezeptoren sowie für Serotonintransporter (SERT) verfügbar. Am Beispiel ausgewählter klinischer Studien werden die speziellen methodischen Einschränkungen und die Schwierigkeiten einer konsistenten Befundinterpretation erläutert.
Derzeit ist zwar eine unmittelbar klinische Anwendung dieser Methodik noch nicht absehbar, dennoch kann die Darstellung des serotonergen Systems in vivo zur Aufklärung der Pathophysiologie wichtiger neuropsychiatrischer Störungen beitragen.

Abstract

The central serotonergic system has an important impact on numerous functions of the central nervous system. Alterations of brain serotonergic activity have been suggested as pathophysiologically and pathogenetically relevant, especially in neuropsychiatric disorders. Therefore serotonergic imaging might be of particular scientific (and clinical) interest. Reliable PET- or SPECT imaging of serotonergic structures (receptors, transporters) is so far impaired by the complex neuroanatomical situation and several methodological limitations. Selected clinical PET- and SPECT-studies with 5HT_1A/2A-receptor and serotonintransporter ligands in neuropsychiatric patients will be presented and critically discussed. To date the clinical relevance of these techniques remains to be established, however, imaging of the serotonergic system might contribute to our further knowledge of brain pathophysiology.

Schlüsselwörter

Serotonin - Psychiatrische Störungen - 5HT-Rezeptor - Serotonintransporter - PET - SPECT

Key words

Serotonin - Psychiatric disorders - 5HT-receptor - Serotonintransporter - PET - SPECT

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