Müller-Vahl K R, Berding G, Brücke T, Kolbe H, Meyer G J, Hundeshagen H, Dengler R, Knapp W H, Emrich H M
Department of Clinical Psychiatry and Psychotherapy, Medical School of Hannover, Germany.
J Neurol. 2000 Jul;247(7):514-20. doi: 10.1007/pl00007806.
Preliminary studies in patients with Gilles de la Tourette syndrome (TS) provided evidence of presynaptic dopaminergic dysfunction, demonstrating increased reuptake sites. Therefore we investigated striatal dopamine transporter binding in 12 TS patients and 9 control subjects using single photon emission computed tomography and 123I-labeled 2beta-carbomethoxy-3beta-(4-iodophenyl)tropane. In TS patients we found significantly higher relative striatal activity ratios (mean +/- SD 12.33 +/- 3.58) than in controls (9.36 +/- 1.35, P< 0.05). Only five patients, however, showed striatum/occipital cortex ratios more than 2 SD above the normal means. Seven patients had activity ratios within the average ratio of the control group plus 2 SD. Regarding the relationship between clinical parameters and striatum/occipital cortex ratios, we found an association between binding ratios and "self-injurious behavior" and "lack of impulse control." This study corroborates previous data suggesting an involvement of the dopaminergic system in TS pathology. Our results demonstrate that an increase in dopamine transporter capacity is a possible but not a necessary alteration, and which appears more likely when self-injurious behavior and lack of impulse control are associated.
对患有抽动秽语综合征（TS）患者的初步研究提供了突触前多巴胺能功能障碍的证据，表明再摄取位点增加。因此，我们使用单光子发射计算机断层扫描和123I标记的2β-甲氧羰基-3β-（4-碘苯基）托烷，对12例TS患者和9例对照受试者的纹状体多巴胺转运体结合情况进行了研究。在TS患者中，我们发现相对纹状体活性比率（平均值±标准差为12.33±3.58）显著高于对照组（9.36±1.35，P<0.05）。然而，只有5例患者的纹状体/枕叶皮质比率比正常平均值高出2个标准差以上。7例患者的活性比率在对照组平均比率加2个标准差范围内。关于临床参数与纹状体/枕叶皮质比率之间的关系，我们发现结合比率与“自我伤害行为”和“缺乏冲动控制”之间存在关联。这项研究证实了先前的数据，表明多巴胺能系统参与了TS的病理过程。我们的结果表明，多巴胺转运体能力的增加是一种可能但非必要的改变，并且当与自我伤害行为和缺乏冲动控制相关联时，这种改变似乎更有可能出现。
