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Abstract：
Novel psychoactive substances (NPSs) have currently become a major public health concern because of relatively easy accessibility to these compounds and difficulty in identifying them with routine laboratory techniques. Here, we report the 18F-fluorodeoxyglucose positron emission tomography/computerized tomography (18F-FDG PET/CT) case study of a 23-year-old man who developed a substance-induced psychotic disorder after having intravenously injected himself with an unspecified amount of methoxetamine (MXE), a ketamine derivative hallucinogen. From a clinical perspective, a blunted affective responsiveness with diminished social drive and sense of purpose, along with a profound detachment from the environment, was observed. Psychometric and neuropsychological assessments highlighted severe dissociative symptoms and lack of motivation, along with a mild impairment of verbal fluency, working memory, and attention. Patient\'s 18F-FDG PET/CT scans displayed a significant bilateral deficit of tracer uptake within the dorsolateral prefrontal cortex (DLPFC). DLPFC activity is critical to goal-oriented cognitive functions, including working memory and sustained attention. DLPFC is also involved in both the temporal integration across multiple sensory modes and in the volitional control of actions, leading to the possibility to construct logically coherent temporal configurations of thought, speech, and behavior. This report highlights that a single acute MXE intoxication may produce severe brain impairment.
摘要：
新型精神活性物质（NPS）目前已成为主要的公共卫生问题，因为这些化合物相对容易获得，并且难以通过常规实验室技术来识别它们。这里,我们报告了18F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDGPET/CT）的案例研究，该案例研究涉及一名23岁的男子，该男子在静脉注射未指明量的甲氧胺（MXE）后发展为物质引起的精神障碍，氯胺酮衍生物致幻剂。从临床的角度来看,一种迟钝的情感反应，社会驱动力和目标感减弱，以及与环境的深刻脱离，被观察到。心理和神经心理学评估强调了严重的分离症状和缺乏动力，加上语言流畅性的轻度损害，工作记忆,和注意。患者的18F-FDGPET/CT扫描显示背侧前额叶皮质（DLPFC）内示踪剂摄取的双侧明显不足。DLPFC活动对于以目标为导向的认知功能至关重要，包括工作记忆和持续注意力。DLPFC还参与了跨多种感觉模式的时间整合和行为的意志控制，导致构建逻辑上连贯的思想时间配置的可能性，演讲,和行为。该报告强调，单一急性MXE中毒可能会导致严重的脑损伤。
