Denys Damiaan, van der Wee Nic, Janssen Joost, De Geus Femke, Westenberg Herman G M
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.
Biol Psychiatry. 2004 May 15;55(10):1041-5. doi: 10.1016/j.biopsych.2004.01.023.
Despite growing evidence for involvement of the dopaminergic system in obsessive-compulsive disorder (OCD), the functional anatomy of the dopaminergic system in the basal ganglia has been investigated sparsely.
Dopamine D(2) receptor binding was assessed in 10 medication-free OCD patients and 10 healthy control subjects, matched for age, gender, and handedness. The binding potential was measured with single photon emission computerized tomography (SPECT) and infusion of the D(2) receptor radiotracer [(123)I] iodobenzamide. With magnetic resonance imaging as reference, regions of interest (caudate and putamen) were delineated for each hemisphere and coregistered with the corresponding SPECT scans.
Dopamine D(2) receptor binding in the left caudate nucleus was significantly lower in the patients with OCD than in healthy control subjects [F(1,18) = 7.0, p =.016]. In addition, an interhemispheric difference was observed in the patient sample. Both the D(2) receptor binding potential (df = 9, p =.012), and the volume (df = 9, p =.029) of the left caudate nucleus were statistically significantly reduced relative to the right caudate nucleus.
This study provides in vivo evidence for abnormalities in the binding potential of the dopamine D(2) receptor, which suggest the direct involvement of the dopaminergic system in the pathophysiology of OCD.
尽管越来越多的证据表明多巴胺能系统参与强迫症(OCD),但基底神经节中多巴胺能系统的功能解剖学研究却很少。
对10名未服用药物的强迫症患者和10名年龄、性别和利手相匹配的健康对照者进行多巴胺D₂受体结合评估。通过单光子发射计算机断层扫描(SPECT)和注入D₂受体放射性示踪剂[¹²³I]碘苄胺来测量结合潜能。以磁共振成像为参考,为每个半球划定感兴趣区域(尾状核和壳核),并与相应的SPECT扫描进行配准。
强迫症患者左侧尾状核中的多巴胺D₂受体结合显著低于健康对照者[F(1,18) = 7.0,p = 0.016]。此外,在患者样本中观察到半球间差异。相对于右侧尾状核,左侧尾状核的D₂受体结合潜能(自由度 = 9,p = 0.012)和体积(自由度 = 9,p = 0.029)在统计学上均显著降低。
本研究为多巴胺D₂受体结合潜能异常提供了体内证据,这表明多巴胺能系统直接参与强迫症的病理生理学过程。