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We carried out dynamic [18F]fallypride PET scans to measure cerebral dopamine D2/3 receptor availability in a 23-year old patient experiencing a severe withdrawal syndrome upon voluntary abstinence from “Spice”, a pre-packaged herbal smoking thought to contain synthetic cannabinoids. Upon admission to the clinic, the patient experienced craving, affective symptoms and a range of somatic complaints, which resolved after several days' monitored abstinence. PET scans were performed on the day of admission, and one week later. Estimates of [18F]fallypride binding potential (BPND) were obtained in striatal and extrastriatal brain regions, and compared to results of age-matched healthy control subjects. Upon admission, [18F]fallypride BPND was reduced by 20% in the patient's striatum and also in extra-striatal regions. During short-term follow-up upon detoxification, the BPND increased to normal values. This study shows substantial short-term alterations of dopamine D2/3 receptor availability in a patient before and after acute detoxification from “Spice Gold”, thus providing first evidence of reversible effects on dopamine receptors of heavy use of a herbal smoking blend.

Die Einbeziehung der Fallbeispiele aus Österreich geschah in erster Linie im Sinne unterschiedlicher Faktorkräfte zu den deutschen Beispielen, sowohl was die externen Rahmenbedingungen staatlicher Entwicklung und internationaler Verflechtung als auch wirtschafts- und regionalpolitische Konzepte sowie Instrumente anging. Die Bewältigung des wirtschaftlichen Strukturwandels, die Steigerung der Wettbewerbsfähigkeit von Unternehmen und Region sowie die Anpassung an die wachsenden Standortanforderungen waren die Ziele der regionalen und kommunalen Wirtschaftspolitik in Verbindung mit den Wirtschafts- und Sozialpartnern in Oberösterreich und im Agglomerationsraum Linz. Möglich wurde die rasche Umsetzung durch finanzielle Beiträge (u.a. des Zukunftsfonds) von öffentlicher Hand und privater Wirtschaft, vor allem aber durch dynamisch und unternehmerisch agierende Einrichtungen, wie etwa die TMG, aber auch der Hochschulen, bis hin zu den jüngsten Aktionen auf internationaler Ebene. Basis sind dabei ohne Zweifel die funktionierenden Netzwerke von Personen, Unternehmen und Institutionen, das vorhandene Vertrauen zwischen den Partnern ("Handschlagqualität") und eine wachsende Gruppe "kluger Köpfe", deren Ideen man sie auch realisieren lässt. Grundlegend war außerdem das Konzept, dass man für jede Maßnahme einen "Kümmerer" eingesetzt hat und es genügend Plattformen gibt, wo sich die Ergebnisse präsentieren lassen (Tagungen, Messen, Austria Business Agency)., The inclusion of case studies from Austria was primarily motivated by the differences in relevant factors from the German examples, both in terms of the external framework conditions of national development, international interconnections, and economic and regional policy concepts and in terms of the instruments applied. The aims of regional and municipal economic policy, together with economic and social partners in Upper Austria and the agglomeration of Linz, were to deal with economic structural change, to enhance the competitive ability of businesses and the region, and to adapt to the growing demands made on locations. The rapid implementation was made possible by financial contributions (for instance from the Future Fund) from the public authorities and private business, but particularly by the dynamic and enterprising activities of institutions such as the TMG and colleges, which even include recent international campaigns. The basis for this is undoubtedly provided by the active networks of people, businesses and institutions, the existent trust between the partners (“based on a handshake”), a growing group of bright minds whose ideas are also implemented, the concept that each measure implemented has a dedicated “trouble shooter” and that there are enough platforms on which results can be presented (congresses, exhibitions, Austria Business Agency).

Positron emission tomography (PET) shows reduced binding of the dopamine D2/3 antagonist [11C]raclopride in striatum of withdrawn psychostimulant abusers, but not consistently in patients with alcohol dependence (AD). We make first use of the high affinity ligand [18F]fallypride to obtain serial measures of D2/3 receptor availability in striatal and extrastriatal regions of AD patients undergoing detoxification. Seventeen patients (mean age 44±5y) with AD and 14 age-matched healthy volunteers participated. Each patient underwent [18F]fallypride PET upon hospital admission, and again 1-2 weeks later; two patients achieving abstinence, and two with substantial harm reduction had additional PET follow-up at 1 year. Dynamic 180-minute PET recordings were used for volume of interest (VOI)-based and voxel-wise analysis of [18F]fallypride binding potential (BPND). Mean baseline BPND in striatum of the AD patients (15.7±3.6) was unaltered during short-term follow-up, and did not differ from that in healthy controls (16.8±3.0); however, BPND was 10-20% lower in thalamus, hippocampus, and insular and temporal cortex of the AD patients (P<0.05). Age-dependent declines in BPND were very small in controls, but more pronounced and widespread in the AD group. Striatal and thalamic BPND increased by 30% in four patients with long-term abstinence or reduced alcohol consumption. VOI-based [18F]fallypride PET analyses revealed group differences in D2/3 receptor availability primarily in extra-striatal regions. Age-related loss of dopamine D2/3 receptors was more pronounced in AD patients. Receptor availability was unaltered by acute withdrawal, but increased in the subgroup of patients with long-term follow-up, suggesting reversibility of receptor changes.