Müller-Vahl Kirsten R, Meyer Geerd J, Knapp Wolfram H, Emrich Hinderk M, Gielow Peter, Brücke Thomas, Berding Georg
Department of Clinical Psychiatry and Psychotherapy, Medical School Hannover, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
Neurosci Lett. 2005 Sep 9;385(2):120-5. doi: 10.1016/j.neulet.2005.05.031.
Recent studies provided evidence for an involvement of the dopaminergic system in the pathophysiology of Tourette Syndrome (TS). However, little is known about possible impairment of other neurotransmitter systems. In obsessive-compulsive disorder (OCD), a common comorbidity in TS, it is suggested that the serotonergic system plays a major role in the pathogenesis. We, therefore, used [I-123]2[beta]-carbomethoxy-3[beta]-(4-iodophenyl)tropane ([123I]beta-CIT) and single photon emission computed tomography (SPECT) to investigate serotonin transporter (SERT) binding capacity in 12 patients with TS with various degrees of associated obsessive compulsive behaviour (OCB) and 16 age-matched healthy controls. Binding ratios in TS patients not receiving serotonin reuptake inhibitors (SSRI) (n=8) were significantly reduced compared to age-adjusted ratios from normal controls (2.8 versus 3.2, p=0.003). Treatment with SSRI resulted in a significant reduction of SERT availability. Performing linear regression analysis for this small group, SSRI-free patients indicated trends for a negative correlation between [123I]beta-CIT binding on SERT and OCB (r=-0.78, p=0.023) as well as complex motor tics (r=-0.68, p=0.064). In healthy controls, but not in the TS group, we found an age-related decline in SERT binding capacity (0.28% decrease per year, p=0.038). Our data are in agreement with previous results suggesting an impairment of the serotonergic system in TS. It can be speculated that the reduction in SERT binding capacity is associated with the degree of comorbid OCB.
近期研究为多巴胺能系统参与抽动秽语综合征（TS）的病理生理学提供了证据。然而，对于其他神经递质系统可能存在的损害却知之甚少。在TS常见的共病强迫症（OCD）中，有观点认为血清素能系统在发病机制中起主要作用。因此，我们使用[I-123]2β-甲氧羰基-3β-（4-碘苯基）托烷（[123I]β-CIT）和单光子发射计算机断层扫描（SPECT），对12例伴有不同程度强迫行为（OCB）的TS患者及16名年龄匹配的健康对照者的血清素转运体（SERT）结合能力进行了研究。未服用血清素再摄取抑制剂（SSRI）的TS患者（n = 8）的结合率与正常对照经年龄校正后的比率相比显著降低（2.8对3.2，p = 0.003）。SSRI治疗导致SERT可用性显著降低。对这个小样本进行线性回归分析时，未服用SSRI的患者显示出[123I]β-CIT在SERT上的结合与OCB（r = -0.78，p = 0.023）以及复杂运动抽动（r = -0.68，p = 0.064）之间呈负相关的趋势。在健康对照者中，而非TS组中，我们发现SERT结合能力存在与年龄相关的下降（每年下降0.28%，p = 0.038）。我们的数据与之前提示TS患者血清素能系统受损的结果一致。可以推测SERT结合能力的降低与共病OCB的程度相关。
