Brambilla F, Bellodi L, Perna G, Arancio C, Bertani A
Psychoneuroendocrine Center, Istituto Scientifico H. San Raffaele, Milan, Italy.
Biol Psychiatry. 1997 Nov 15;42(10):889-97. doi: 10.1016/S0006-3223(96)00549-5.
Indirect observations suggest that the dopaminergic system may be involved in the pathophysiology of obsessive-compulsive disorder (OCD). The dopaminergic function of 15 patients with OCD and 15 age/sex-matched controls was evaluated by measuring the growth hormone (GH) responses to stimulation with the dopaminergic agonist apomorphine (APO), which increases growth hormone-releasing hormone (GHRH), GH, and somatomedine C (SMD-C) secretions. Therefore, we measured basal plasma GH and SMD-C concentrations and GH responses to GHRH stimulation to exclude that a downstream pathology of the somatotropic axis could obscure the significance of the results of the APO test. The response of prolactin (PRL) to APO inhibition were also measured. Basal plasma levels of GH, SMD-C, and PRL, GH responses to GHRH stimulation, and PRL responses to APO inhibition did not differ in the two groups of subjects. GH responses to APO stimulation were blunted in obsessive-compulsive (OC) patients. The emetic response to the same stimulation was stronger in patients than in controls. These responses suggest that in our OC patients there is a dysregulation of the dopaminergic system, which is possibly expressed in different ways in the various areas of the central nervous system.
间接观察表明,多巴胺能系统可能参与强迫症(OCD)的病理生理过程。通过测量生长激素(GH)对多巴胺能激动剂阿扑吗啡(APO)刺激的反应来评估15例强迫症患者和15例年龄/性别匹配的对照者的多巴胺能功能,阿扑吗啡可增加生长激素释放激素(GHRH)、GH和生长调节素C(SMD-C)的分泌。因此,我们测量了基础血浆GH和SMD-C浓度以及GH对GHRH刺激的反应,以排除生长激素轴的下游病变可能掩盖APO试验结果的意义。还测量了催乳素(PRL)对APO抑制的反应。两组受试者的基础血浆GH、SMD-C和PRL水平、GH对GHRH刺激的反应以及PRL对APO抑制的反应均无差异。强迫症(OC)患者对APO刺激的GH反应减弱。患者对相同刺激的催吐反应比对照者更强。这些反应表明,在我们的OC患者中存在多巴胺能系统的失调,这可能在中枢神经系统的各个区域以不同方式表现出来。