Leckman J F, Goodman W K, North W G, Chappell P B, Price L H, Pauls D L, Anderson G M, Riddle M A, McSwiggan-Hardin M, McDougle C J
Child Study Center, Yale University School of Medicine, New Haven, Conn.
Arch Gen Psychiatry. 1994 Oct;51(10):782-92. doi: 10.1001/archpsyc.1994.03950100030003.
Limited neurobiological data have implicated central arginine vasopressin in the pathobiology of obsessive-compulsive disorder (OCD). Based on twin, family genetic, and pharmacological studies, some forms of OCD are etiologically related to Tourette's syndrome. The role of arginine vasopressin and related compounds such as oxytocin in Tourette's syndrome has not been previously explored.
To compare cerebrospinal fluid (CSF) levels of arginine vasopressin and oxytocin, we collected CSF at midday in a standardized fashion from a total of 83 individuals (29 patients with OCD, 23 patients with Tourette's syndrome, and 31 normal controls). We also collected family study data on each subject to determine which subjects had a family history positive for Tourette's syndrome, OCD, or related syndromes.
In contrast to previous reports, we report similar concentrations of arginine vasopressin for all three groups but increased oxytocin levels in patients with OCD. Remarkably, this increase was observed only in a subset of patients with OCD (n = 22) independently identified as being without a personal or family history of tic disorders (P = .0003). In this subgroup of patients, the CSF oxytocin level was correlated with current severity of OCD (n = 19, r = .47, P < .05).
A possible role for oxytocin in the neurobiology of a subtype of OCD is suggested by the elevated CSF levels of oxytocin and by the correlation between CSF oxytocin levels and OCD severity. These findings reinforce the value of family genetic data in identifying biologically homogeneous (and perhaps more etiologically homogeneous) groups of patients with OCD. Together with emerging pharmacological data showing differential responsiveness to treatment of tic-related OCD vs non-tic-related OCD, these data also argue strongly for the incorporation of tic-relatedness as a variable in biological and behavioral studies of patients with OCD.
有限的神经生物学数据表明，中枢精氨酸加压素与强迫症（OCD）的病理生物学有关。基于双胞胎、家族遗传学和药理学研究，某些形式的强迫症在病因上与妥瑞氏综合征有关。精氨酸加压素及相关化合物如催产素在妥瑞氏综合征中的作用此前尚未得到研究。
为比较精氨酸加压素和催产素的脑脊液（CSF）水平，我们以标准化方式于中午从总共83名个体（29名强迫症患者、23名妥瑞氏综合征患者和31名正常对照）中采集了脑脊液。我们还收集了每个受试者的家族研究数据，以确定哪些受试者有妥瑞氏综合征、强迫症或相关综合征的家族史阳性。
与之前的报告不同，我们报告三组的精氨酸加压素浓度相似，但强迫症患者的催产素水平升高。值得注意的是，这种升高仅在一组独立确定没有抽动障碍个人或家族史的强迫症患者中观察到（n = 22，P = .0003）。在这组患者中，脑脊液催产素水平与强迫症的当前严重程度相关（n = 19，r = .47，P < .05）。
脑脊液中催产素水平升高以及脑脊液催产素水平与强迫症严重程度之间的相关性表明，催产素在一种强迫症亚型的神经生物学中可能发挥作用。这些发现强化了家族遗传数据在识别生物学上同质（可能在病因上也更同质）的强迫症患者群体中的价值。连同新出现的药理学数据显示抽动相关强迫症与非抽动相关强迫症对治疗的反应不同，这些数据也有力地支持将抽动相关性作为强迫症患者生物学和行为研究中的一个变量。
