Akkus Funda, Terbeck Sylvia, Ametamey Simon M, Rufer Michael, Treyer Valerie, Burger Cyrill, Johayem Anass, Mancilla Baltazar Gomez, Sovago Judit, Buck Alfred, Hasler Gregor
Psychiatric University Hospital, University of Bern,BernSwitzerland.
Department of Chemistry and Applied Biosciences of ETH,Centre for Radiopharmaceutical Science of ETH,PSI and USZ, Zurich,Switzerland.
Int J Neuropsychopharmacol. 2014 Dec;17(12):1915-22. doi: 10.1017/S1461145714000716. Epub 2014 May 15.
Obsessive-compulsive disorder (OCD) is a disabling, mostly chronic, psychiatric condition with significant social and economic impairments and is a major public health issue. However, numerous patients are resistant to currently available pharmacological and psychological interventions. Given that recent animal studies and magnetic resonance spectroscopy research points to glutamate dysfunction in OCD, we investigated the metabotropic glutamate receptor 5 (mGluR5) in patients with OCD and healthy controls. We determined mGluR5 distribution volume ratio (DVR) in the brain of ten patients with OCD and ten healthy controls by using [11C]ABP688 positron-emission tomography. As a clinical measure of OCD severity, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was employed. We found no significant global difference in mGluR5 DVR between patients with OCD and healthy controls. We did, however, observe significant positive correlations between the Y-BOCS obsession sub-score and mGluR5 DVR in the cortico-striatal-thalamo-cortical brain circuit, including regions of the amygdala, anterior cingulate cortex, and medial orbitofrontal cortex (Spearman's ρ's⩾ = 0.68, p < 0.05). These results suggest that obsessions in particular might have an underlying glutamatergic pathology related to mGluR5. The research indicates that the development of metabotropic glutamate agents would be useful as a new treatment for OCD.
强迫症(OCD)是一种致残性的、大多为慢性的精神疾病,会造成重大的社会和经济损害,是一个重大的公共卫生问题。然而,许多患者对目前可用的药物和心理干预有抗性。鉴于最近的动物研究和磁共振波谱研究表明强迫症存在谷氨酸功能障碍,我们对强迫症患者和健康对照者的代谢型谷氨酸受体5(mGluR5)进行了研究。我们通过使用[11C]ABP688正电子发射断层扫描来测定10名强迫症患者和10名健康对照者大脑中的mGluR5分布体积比(DVR)。作为强迫症严重程度的临床指标,采用了耶鲁-布朗强迫症量表(Y-BOCS)。我们发现强迫症患者和健康对照者之间的mGluR5 DVR没有显著的总体差异。然而,我们确实观察到在皮质-纹状体-丘脑-皮质脑回路中,包括杏仁核、前扣带回皮质和内侧眶额皮质区域,Y-BOCS强迫观念子评分与mGluR5 DVR之间存在显著的正相关(斯皮尔曼相关系数ρ⩾ = 0.68,p < 0.05)。这些结果表明,特别是强迫观念可能存在与mGluR5相关的潜在谷氨酸能病理。该研究表明,开发代谢型谷氨酸药物将有助于作为强迫症的一种新治疗方法。