Vulink Nienke C, Planting Robin S, Figee Martijn, Booij Jan, Denys Damiaan
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Eur Neuropsychopharmacol. 2016 Feb;26(2):350-356. doi: 10.1016/j.euroneuro.2015.11.018. Epub 2015 Nov 30.
Though the dopaminergic system is implicated in Obsessive Compulsive and Related Disorders (OCRD), the dopaminergic system has never been investigated in-vivo in Body Dysmorphic Disorder (BDD). In line with consistent findings of reduced striatal dopamine D2/3 receptor availability in Obsessive Compulsive Disorder (OCD), we hypothesized that the dopamine D2/3 receptor availability in the striatum will be lower in patients with BDD in comparison to healthy subjects. Striatal dopamine D2/3 receptor Binding Potential (BPND) was examined in 12 drug-free BDD patients and 12 control subjects pairwise matched by age, sex, and handedness using [(123)I]iodobenzamide Single Photon Emission Computed Tomography (SPECT; bolus/constant infusion technique). Regions of interest were the caudate nucleus and the putamen. BPND was calculated as the ratio of specific striatal to binding in the occipital cortex (representing nonspecific binding). Compared to controls, dopamine D2/3 receptor BPND was significantly lower in BDD, both in the putamen (p=0.017) and caudate nucleus (p=0.022). This study provides the first evidence of a disturbed dopaminergic system in BDD patients. Although previously BDD was classified as a separate disorder (somatoform disorder), our findings give pathophysiological support for the recent reclassification of BDD to the OCRD in DSM-5.
尽管多巴胺能系统与强迫及相关障碍（OCRD）有关，但从未在体研究过身体变形障碍（BDD）中的多巴胺能系统。与强迫症（OCD）纹状体多巴胺D2/3受体可用性降低的一致研究结果相符，我们假设与健康受试者相比，BDD患者纹状体中的多巴胺D2/3受体可用性会更低。使用[（123）I]碘苯甲酰胺单光子发射计算机断层扫描（SPECT；团注/持续输注技术），对12名未服用药物的BDD患者和12名按年龄、性别和利手进行配对的对照受试者的纹状体多巴胺D2/3受体结合潜能（BPND）进行了检查。感兴趣的区域是尾状核和壳核。BPND计算为纹状体特异性结合与枕叶皮质结合（代表非特异性结合）的比值。与对照组相比，BDD患者的多巴胺D2/3受体BPND在壳核（p = 0.017）和尾状核（p = 0.022）中均显著降低。这项研究首次证明了BDD患者的多巴胺能系统紊乱。尽管之前BDD被归类为一种单独的障碍（躯体形式障碍），但我们的研究结果为最近在《精神疾病诊断与统计手册》第5版中将BDD重新归类为OCRD提供了病理生理学支持。
