Chappell P, Leckman J, Goodman W, Bissette G, Pauls D, Anderson G, Riddle M, Scahill L, McDougle C, Cohen D
Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
Biol Psychiatry. 1996 May 1;39(9):776-83. doi: 10.1016/0006-3223(95)00221-9.
Stress- and anxiety-related fluctuations in tic severity are cardinal features of Tourette's syndrome (TS), and there is evidence for involvement of noradrenergic mechanisms in the pathophysiology and treatment of the disorder. To examine further the pathobiology of this enhanced vulnerability to stress and anxiety, we measured central activity of corticotropin-releasing factor (CRF) in patients with TS and the related condition, obsessive compulsive disorder (OCD). Lumbar cerebrospinal fluid (CSF) was obtained in a standardized fashion for measurement of CRF from 21 medication-free outpatients with TS, 20 with OCD, and 29 healthy controls. The TS patients had significantly higher levels of CSF CRF than both the normal controls and the OCD patients. However, there was no difference in CSF CRF between the OCD patients and the normal controls. Group differences in CSF CRF were unrelated to current clinical ratings of depression, anxiety, tics, and obsessive compulsive behaviors. Although the functional significance of this finding remains to be elucidated, these results are consistent with the hypothesis that stress-related neurobiological mechanisms may play a role in the pathobiology of TS.
抽动严重程度与压力和焦虑相关的波动是妥瑞氏症（TS）的主要特征，并且有证据表明去甲肾上腺素能机制参与了该疾病的病理生理学和治疗过程。为了进一步研究这种对压力和焦虑易感性增强的病理生物学机制，我们测量了妥瑞氏症患者以及相关疾病强迫症（OCD）患者体内促肾上腺皮质激素释放因子（CRF）的中枢活性。以标准化方式采集了21名未服用药物的妥瑞氏症门诊患者、20名强迫症患者和29名健康对照者的腰椎脑脊液（CSF），用于测量CRF。妥瑞氏症患者脑脊液中CRF水平显著高于正常对照者和强迫症患者。然而，强迫症患者与正常对照者脑脊液中CRF水平并无差异。脑脊液中CRF的组间差异与当前抑郁、焦虑、抽动以及强迫行为的临床评分无关。尽管这一发现的功能意义仍有待阐明，但这些结果与压力相关神经生物学机制可能在妥瑞氏症病理生物学中起作用的假设一致。
