Zoons E, Tijssen M A J, Dreissen Y E M, Speelman J D, Smit M, Booij J
Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands.
Department of Neurology, University Medical Centre, Groningen, The Netherlands.
Eur J Nucl Med Mol Imaging. 2017 Aug;44(8):1375-1382. doi: 10.1007/s00259-017-3664-x. Epub 2017 Mar 17.
Cervical dystonia (CD) is associated with tremor/jerks (50%) and psychiatric complaints (17-70%). The dopaminergic system has been implicated in the pathophysiology of CD in animal and imaging studies. Dopamine may be related to the motor as well as non-motor symptoms of CD. CD is associated with reduced striatal dopamine D (D2/3) receptor and increased dopamine transporter (DAT) binding. There are differences in the dopamine system between CD patients with and without jerks/tremor and psychiatric symptoms.
Patients with CD and healthy controls underwent neurological and psychiatric examinations. Striatal DAT and D2/3 receptor binding were assessed using [I]FP-CIT and [I]IBZM SPECT, respectively. The ratio of specific striatal to non-specific binding (binding potential; BP) was the outcome measure.
Twenty-seven patients with CD and 15 matched controls were included. Nineteen percent of patients fulfilled the criteria for a depression. Striatal DAT BP was significantly lower in depressed versus non-depressed CD patients. Higher DAT BP correlated significantly with higher scores on the Unified Myoclonus Rating Scale (UMRS). The striatal D2/3 receptor BP in CD patients showed a trend towards lower binding compared to controls. The D2/3 BP was significantly lower in depressed versus non-depressed CD patients. A significant correlation between DAT and D2/3R BP was found in both in patients and controls.
Alterations of striatal DAT and D2/3 receptor binding in CD patients are related mainly to depression. DAT BP correlates significantly with scores on the UMRS, suggesting a role for dopamine in the pathophysiology of tremor/jerks in CD.
颈部肌张力障碍（CD）与震颤/抽搐（50%）及精神症状（17 - 70%）相关。在动物和影像学研究中，多巴胺能系统已被认为与CD的病理生理学有关。多巴胺可能与CD的运动及非运动症状均相关。CD与纹状体多巴胺D（D2/3）受体减少及多巴胺转运体（DAT）结合增加有关。有震颤/抽搐及精神症状和无这些症状的CD患者之间，多巴胺系统存在差异。
CD患者和健康对照者接受神经学和精神学检查。分别使用[I]FP - CIT和[I]IBZM单光子发射计算机断层扫描（SPECT）评估纹状体DAT和D2/3受体结合情况。以特异性纹状体与非特异性结合的比率（结合潜能；BP）作为观察指标。
纳入27例CD患者和15例匹配的对照者。19%的患者符合抑郁症标准。与非抑郁的CD患者相比，抑郁的CD患者纹状体DAT BP显著降低。较高的DAT BP与统一肌阵挛评定量表（UMRS）的较高得分显著相关。与对照相比，CD患者纹状体D2/3受体BP有降低的趋势。与非抑郁的CD患者相比，抑郁的CD患者D2/3 BP显著降低。在患者和对照中均发现DAT和D2/3R BP之间存在显著相关性。
CD患者纹状体DAT和D2/3受体结合的改变主要与抑郁症有关。DAT BP与UMRS得分显著相关，提示多巴胺在CD震颤/抽搐的病理生理学中起作用。
