Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; The Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands.
Eur Neuropsychopharmacol. 2013 Nov;23(11):1423-31. doi: 10.1016/j.euroneuro.2013.05.012. Epub 2013 Jul 19.
Tourette syndrome (TS) and obsessive-compulsive disorder (OCD) both are neuropsychiatric disorders associated with abnormalities in dopamine neurotransmission. Aims of this study were to quantify striatal D2/3 receptor availability in TS and OCD, and to examine dopamine release and symptom severity changes in both disorders following amphetamine challenge. Changes in [(11)C]raclopride binding potential (BP(ND)) were assessed using positron emission tomography before and after administration of d-amphetamine (0.3 mg kg(-1)) in 12 TS patients without comorbid OCD, 12 OCD patients without comorbid tics, and 12 healthy controls. Main outcome measures were baseline striatal D2/3 receptor BP(ND) and change in BP(ND) following amphetamine as a measure of dopamine release. Voxel-based analysis revealed significantly decreased baseline [(11)C]raclopride BP(ND) in bilateral putamen of both patient groups vs. healthy controls, differences being more pronounced in the TS than in the OCD group. Changes in BP(ND) following amphetamine were not significantly different between groups. Following amphetamine administration, tic severity increased in the TS group, which correlated with BP(ND) changes in right ventral striatum. Symptom severity in the OCD group did not change significantly following amphetamine challenge and was not associated with changes in BP(ND). This study provides evidence for decreased striatal D2/3 receptor availability in TS and OCD, presumably reflecting higher endogenous dopamine levels in both disorders. In addition, it provides the first direct evidence that ventral striatal dopamine release is related to the pathophysiology of tics.
妥瑞氏症（TS）和强迫症（OCD）都是与多巴胺神经传递异常相关的神经精神疾病。本研究的目的是量化 TS 和 OCD 中的纹状体 D2/3 受体可用性，并研究两种疾病在安非他命挑战后多巴胺释放和症状严重程度的变化。在给予 d-安非他命（0.3mg/kg）前后，通过正电子发射断层扫描评估 12 名无共患 OCD 的 TS 患者、12 名无共患抽搐的 OCD 患者和 12 名健康对照者的 [(11)C]raclopride 结合潜能（BP(ND)）的变化。主要的测量指标是基线纹状体 D2/3 受体 BP(ND)和安非他命后 BP(ND)的变化，作为多巴胺释放的衡量标准。基于体素的分析显示，两组患者双侧壳核的 [(11)C]raclopride BP(ND)基线均显著降低，TS 组的差异比 OCD 组更为明显。组间安非他命后 BP(ND)的变化无显著差异。在给予安非他命后，TS 组的抽搐严重程度增加，这与右侧腹侧纹状体的 BP(ND)变化相关。OCD 组在安非他命挑战后症状严重程度没有显著变化，也与 BP(ND)的变化无关。本研究提供了 TS 和 OCD 中纹状体 D2/3 受体可用性降低的证据，推测这两种疾病的内源性多巴胺水平较高。此外，它提供了第一个直接证据，表明腹侧纹状体的多巴胺释放与抽搐的病理生理学有关。
