Albin R L, Koeppe R A, Bohnen N I, Nichols T E, Meyer P, Wernette K, Minoshima S, Kilbourn M R, Frey K A
Department of Neurology, The University of Michigan Medical School, Ann Arbor, USA.
Neurology. 2003 Aug 12;61(3):310-5. doi: 10.1212/01.wnl.0000076181.39162.fc.
Excessive striatal dopaminergic innervation is suggested to underlie Tourette syndrome (TS). Prior imaging and postmortem studies yield conflicting data.
The authors used PET with the type 2 vesicular monoamine transporter ligand [(11)C]dihydrotetrabenazine (DTBZ) to quantify striatal monoaminergic innervation in patients with TS (n = 19) and control subjects (n = 27). Compartmental modeling was used to determine blood to brain ligand transport (K(1)) and tissue to plasma distribution volume (a measure of ligand binding) during continuous infusion of DTBZ. TS data were compared with control data using predefined regions of interest and on a voxel by voxel basis.
There were no significant differences in ligand binding or ligand transport between patients with TS and control subjects in the dorsal striatum. With voxel by voxel analysis, there was increased DTBZ binding in the right ventral striatum.
Previously reported differences between patients with TS and control subjects in dorsal striatal dopamine terminal markers may reflect medication-induced regulation of terminal marker expression or be the result of intrinsic differences in striatal dopaminergic synaptic function. Increased right ventral striatal DTBZ binding suggests that abnormal ventral striatal dopaminergic innervation may underlie tics.
纹状体多巴胺能神经支配过度被认为是抽动秽语综合征（TS）的基础。先前的影像学和尸检研究得出了相互矛盾的数据。
作者使用正电子发射断层扫描（PET）和2型囊泡单胺转运体配体[（11）C]二氢四苯嗪（DTBZ）来量化TS患者（n = 19）和对照受试者（n = 27）的纹状体单胺能神经支配。在持续输注DTBZ期间，采用房室模型来确定血脑配体转运（K（1））和组织与血浆的分布容积（配体结合的一种测量方法）。使用预定义的感兴趣区域并逐体素地将TS数据与对照数据进行比较。
TS患者和对照受试者在背侧纹状体中的配体结合或配体转运没有显著差异。通过逐体素分析，右侧腹侧纹状体中DTBZ结合增加。
先前报道的TS患者和对照受试者在背侧纹状体多巴胺终末标志物方面的差异可能反映了药物诱导的终末标志物表达调节，或者是纹状体多巴胺能突触功能内在差异的结果。右侧腹侧纹状体DTBZ结合增加表明腹侧纹状体多巴胺能神经支配异常可能是抽动的基础。
