Brain Regional α-[11C]Methyl-L-Tryptophan Trapping in Medication-Free Patients With Obsessive-Compulsive Disorder

被引：20

作者：

Berney, Alexandre ^{[1
,2
]}

Leyton, Marco ^{[1
,2
]}

Gravel, Paul ^{[1
,2
]}

Sibon, Igor ^{[1
,2
]}

Sookman, Debbie ^{[1
,3
]}

Rosa Neto, Pedro ^{[1
,2
]}

Diksic, Mirko ^{[2
]}

Nakai, Akio ^{[2
]}

Pinard, Gilbert ^{[1
]}

Todorov, Christo ^{[4
]}

Okazawa, Hidehiko ^{[2
]}

Blier, Pierre ^{[1
]}

Nordahl, Thomas Edward ^{[5
]}

Benkelfat, Chawki ^{[1
,2
]}

机构：

[1] McGill Univ, Dept Psychiat, Montreal, PQ H3A 1A1, Canada

[2] McGill Univ, Montreal Neurol Inst, McConnell Brain Imaging Ctr, Dept Neurol & Neurosurg, Montreal, PQ H3A 1A1, Canada

[3] McGill Univ, Ctr Hlth, Dept Psychol, Obsess Compuls Disorder Clin, Montreal, PQ H3A 1A1, Canada

[4] Univ Montreal, LH Lafontaine Hosp, Dept Psychiat, Quebec City, PQ, Canada

[5] UC Davis Med Ctr, Dept Psychiat & Behav Sci, Sacramento, CA USA

来源：

ARCHIVES OF GENERAL PSYCHIATRY | 2011年 / 68卷 / 07期

关键词：

METHYL-L-TRYPTOPHAN; SEROTONIN TRANSPORTER-AVAILABILITY; POSITRON-EMISSION-TOMOGRAPHY; GLUCOSE METABOLIC-RATES; M-CHLOROPHENYLPIPERAZINE; SYNTHESIS CAPACITY; META-CHLOROPHENYLPIPERAZINE; PREFRONTAL CORTEX; CAUDATE-NUCLEUS; 5-HT SYNTHESIS;

D O I：

10.1001/archgenpsychiatry.2011.16

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Context: The hypothesis of a serotonin (5-hydroxytryptamine [5-HT]) dysfunction in obsessive-compulsive disorder (OCD) stems largely from the clinical efficacy of 5-HT reuptake inhibitors. Serotonergic abnormalities in the unmedicated symptomatic state, however, remain to be fully characterized. Objective: To investigate brain regional 5-HT synthesis, as indexed by positron emission tomography and the alpha-[C-11]methyl-L-tryptophan trapping constant (K*), in treatment-free adults meeting criteria for OCD. Design: Between-group comparison. Setting: Department of Psychiatry and Montreal Neurological Institute, McGill University, and Department of Psychology, McGill University Health Centre, Quebec, Canada. Participants: Twenty-one medication-free patients with OCD (15 men with a mean [SD] age of 33.2 [9.3] years and 6 women with a mean [SD] age of 35.8 [7.1] years) and 21 healthy controls matched for age and sex (15 men with a mean [SD] age of 32.9 [10.1] years and 6 women with a mean [SD] age of 36.5.5 [8.6] years). Main Outcome Measure: The alpha-[C-11]methyl-L-tryptophan brain trapping constant K*, which was analyzed with Statistical Parametric Mapping (SPM8) and with proportional normalization (extent threshold of 100 voxels with a peak threshold of P <= .005). Results: Compared with healthy controls, the patients with OCD exhibited significantly greater alpha-[C-11]methyl-L-tryptophan trapping in the right hippocampus and left temporal gyrus (Brodmann area 20). In the larger subsample of all men, these same differences were also evident, as well as higher K* values in the caudate nucleus. Individual differences in symptom severity correlated positively with K* values sampled from the caudate and temporal lobe of the patients with OCD, respectively. There were no regions where the patients exhibited abnormally low K* values. Volumetric analyses found no morphometric alterations that would account for the group differenees. Conclusion: The results support previous reports of greater striatal and temporal lobe activity in patients with OCD than in healthy controls and suggest that these disturbances include a serotonergic component. Previously reported glucose metabolic disturbances in OCD involving the orbitofrontal and cingulate cortices, in comparison, might reflect postsynaptic changes in the serotonergic system.

引用

页码：732 / 741

页数：10

共 126 条

[1] Patients with obsessive-compulsive disorder have increased 5-HT2A receptor binding in the caudate nuclei [J].