van der Wee Nic J, Stevens Henk, Hardeman Johannes A, Mandl Rene C, Denys Damiaan A, van Megen Harold J, Kahn René S, Westenberg Herman M
Department of Psychiatry, Leiden University Medical Center, B1-P, P.O. Box 9600, 2300 RC, Leiden, the Netherlands.
Am J Psychiatry. 2004 Dec;161(12):2201-6. doi: 10.1176/appi.ajp.161.12.2201.
The authors examine the functional anatomy of serotonergic and dopaminergic systems in obsessive-compulsive disorder in psychotropic-naive patients without comorbidity.
[(123)I]beta-CIT binding patterns for dopamine and serotonin transporters in the brain were measured in 15 psychotropic-naive adult outpatients with OCD (no comorbidity) and in 15 pairwise-matched healthy subjects. Volumes of interest were constructed on magnetic resonance imaging scans and coregistered with single photon emission computed tomography scans. Binding ratios were compared, and possible correlations between binding patterns and obsessive-compulsive symptoms were assessed.
There were significant differences between patients and healthy subjects in the [(123)I]beta-CIT binding pattern for dopamine transporter in the left caudate and left putamen. Patients had higher binding ratios than healthy subjects. No differences were found in the less specific [(123)I]beta-CIT binding pattern for serotonin transporters in the selected volumes of interest. Hemispheric within-group comparisons revealed no asymmetry effects.
The results of our study provide direct evidence for an involvement of the dopaminergic system in the pathophysiology of OCD.
作者研究了未合并其他疾病且未接受过精神药物治疗的强迫症患者中血清素能和多巴胺能系统的功能解剖结构。
在15名未接受过精神药物治疗的成年强迫症门诊患者（无合并症）和15名配对的健康受试者中，测量大脑中多巴胺和血清素转运体的[(123)I]β-CIT结合模式。在磁共振成像扫描上构建感兴趣区域，并与单光子发射计算机断层扫描进行配准。比较结合率，并评估结合模式与强迫症状之间可能的相关性。
患者与健康受试者在左尾状核和左壳核中多巴胺转运体的[(123)I]β-CIT结合模式上存在显著差异。患者的结合率高于健康受试者。在选定的感兴趣区域中，血清素转运体的[(123)I]β-CIT结合模式特异性较低，未发现差异。半球内组间比较未发现不对称效应。
我们的研究结果为多巴胺能系统参与强迫症的病理生理学提供了直接证据。
