Leckman J F, Goodman W K, Anderson G M, Riddle M A, Chappell P B, McSwiggan-Hardin M T, McDougle C J, Scahill L D, Ort S I, Pauls D L
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
Neuropsychopharmacology. 1995 Feb;12(1):73-86. doi: 10.1038/sj.npp.1380241.
To examine the role of noradrenergic, dopaminergic, and serotonergic mechanisms in the pathobiology of obsessive compulsive disorder (OCD) and Tourette's syndrome (TS), concentrations of tyrosine (TYR), norepinephrine (NE), 3-methoxy-4-hydroxyphenylethylene glycol (MHPG), homovanillic acid (HVA), tryptophan (TRP), and 5-hydroxyindoleacetic acid (5-HIAA) were measured in the lumbar cerebrospinal fluid (CSF) of 39 medication-free OCD patients, 33 medication-free TS patients, and 44 healthy volunteers. CSF TYR concentrations were reduced (p < .05) in the OCD patients compared to the healthy subjects. CSF NE in TS patients was 55% higher than in healthy controls (p < .001) and 35% higher than in OCD patients (p < .001). After covarying for height, CSF HVA levels were reduced (p < .05) in the OCD group compared to TS patients but not compared to the normal volunteers. No mean differences in CSF MHPG, TRP, and 5-HIAA were observed in this study across the three groups. The CSF NE data support the hypothesis that noradrenergic mechanisms are involved in the pathobiology of TS. Alterations in the balance of noradrenergic, dopaminergic, and serotonergic systems are likely involved in the pathobiology of OCD.
为研究去甲肾上腺素能、多巴胺能和5-羟色胺能机制在强迫症（OCD）和抽动秽语综合征（TS）病理生物学中的作用，对39名未服用药物的OCD患者、33名未服用药物的TS患者和44名健康志愿者的腰椎脑脊液（CSF）中酪氨酸（TYR）、去甲肾上腺素（NE）、3-甲氧基-4-羟基苯乙二醇（MHPG）、高香草酸（HVA）、色氨酸（TRP）和5-羟吲哚乙酸（5-HIAA）的浓度进行了测量。与健康受试者相比，OCD患者的脑脊液TYR浓度降低（p <.05）。TS患者的脑脊液NE比健康对照者高55%（p <.001），比OCD患者高35%（p <.001）。在对身高进行协变量调整后，与TS患者相比，OCD组的脑脊液HVA水平降低（p <.05），但与正常志愿者相比无差异。在本研究中，三组之间脑脊液MHPG、TRP和5-HIAA未观察到平均差异。脑脊液NE数据支持去甲肾上腺素能机制参与TS病理生物学的假说。去甲肾上腺素能、多巴胺能和5-羟色胺能系统平衡的改变可能参与了OCD的病理生物学过程。
