Article1998

Tourette's syndrome

Andreas Heinz · Michael B. Knable · Steven S. Wolf · Julia G. Gorey · T M Hyde · Daniel R. Weinberger

95 citations0/0 files storedNeurology

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Obsessive-Compulsive Spectrum Disorders Neurotransmitter Receptor Influence on Behavior Neurological disorders and treatments

Abstract

OBJECTIVE: To examine in vivo the density of brain monoaminergic transporters in Tourette's syndrome (TS). BACKGROUND: TS is a heritable neuropsychiatric disorder characterized by chronic vocal and motor tics and is often associated with obsessive-compulsive symptoms. Hyperstimulation of dopamine receptors and dysfunction of serotonergic transmission have been implicated in its pathogenesis, but direct evidence of involvement of these neurochemical systems has been limited. METHODS: Symptom severity and the availability of presynaptic monoaminergic transporters in the basal ganglia, midbrain, and thalamus were measured using SPECT and the radioligand [I-123]2beta-carbomethoxy-3beta-(4-iodophenyl)tropane ([I-123]beta-CIT) in 10 patients with TS and in 10 age- and sex-matched normal volunteers. RESULTS: A significant negative correlation was found between a measure of overall tic severity and beta-CIT binding in the midbrain (r = -0.73, p = 0.02) and the thalamus (r = -0.82, p < 0.01). When examined post hoc, these correlations were determined largely by vocal tic severity. No other significant correlations were found between symptom severity and beta-CIT binding in the striatum or cortex. CONCLUSIONS: These findings indicate that serotonergic neurotransmission in the midbrain and serotonergic or noradrenergic neurotransmission in the thalamus may be important factors in the expression of TS and may suggest novel targets for treatment.

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References

1989The Yale Global Tic Severity Scale: Initial Testing of a Clinician-Rated Scale of Tic Severity 1992Caudate Glucose Metabolic Rate Changes With Both Drug and Behavior Therapy for Obsessive-Compulsive Disorder 1987Local Cerebral Glucose Metabolic Rates in Obsessive-Compulsive Disorder 1996Tourette Syndrome: Prediction of Phenotypic Variation in Monozygotic Twins by Caudate Nucleus D2 Receptor Binding 1982Dopaminergic dysfunction in tourette syndrome 1995Grief: normal and pathological variants

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2000Dopamine transporter binding in Gilles de la Tourette syndrome 2003Pathophysiology of Tourette's syndrome: striatal pathways revisited 2004Dopamine transporter density of the basal ganglia assessed with [123I]IPT SPECT in drug-naive children with Tourette's disorder 2006Dopaminergic polymorphisms in Tourette syndrome: Association with the DAT gene (SLC6A3)2008Neurobiological basis of serotonin–dopamine antagonists in the treatment of Gilles de la Tourette syndrome 2007Reduced availability of serotonin transporters in obsessive-compulsive disorder correlates with symptom severity – a [11C]DASB PET study

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