Tourette's syndrome

Heinz, Andreas; Knable, Michael B.; Wolf, Steven S.; Jones, Douglas W.; Gorey, Julia G.; Hyde, T M; Weinberger, Daniel R.

doi:10.1212/wnl.51.4.1069

Cited by 93 publications

(53 citation statements)

References 7 publications

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“…This result is in agreement with a b-CIT SPECT study in patients with Tourette's syndrome (TS), a disorder characterized by chronic tics often accompanied by obsessive-compulsive symptoms (OCD-spectrum disorder). Heinz et al (1998a) found a significant negative correlation between midbrain b-CIT binding and vocal tic severity in these patients. Correlations between b-CIT ratios and OCD severity (Y-BOCS scores) were also calculated in all previously mentioned b-CIT OCD studies.…”

Section: Discussionmentioning

confidence: 62%

“…However, no significant correlations were found in any of these investigations. Again one must keep in mind that these negative results are most likely dependent upon the heterogeneity of the OCD patients, because not only our study with a homogeneous subtype but also that of Heinz et al (1998a) in TS patients showed significant correlations.…”

Section: Discussionmentioning

confidence: 68%

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[123I]-β-CIT SPECT Imaging Shows Reduced Thalamus–Hypothalamus Serotonin Transporter Availability in 24 Drug-Free Obsessive-Compulsive Checkers

Zitterl

Aigner

Stompe

et al. 2006

Neuropsychopharmacol

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Numerous findings indicate alterations in brain serotonin systems in obsessive-compulsive disorder (OCD). We investigated the in vivo availability of thalamus-hypothalamus serotonin transporters (SERT) in patients with DSM-IV OCD who displayed prominent behavioral checking compulsions (OC-checkers). Four hours after injection of [ 123 I]-2b-carbomethoxy-3b-(4-iodophenyl)tropane ([ 123 I]-b-CIT), single photon emission computed tomography (SPECT) scans were performed in 24 medication-free non-depressed OC-checkers and 24 age-and gender-matched healthy controls. For quantification of brain serotonin transporter availability, a ratio of specific to non-displaceable [ 123 I]-b-CIT brain binding was used (V 00 3 ¼ (thalamus and hypothalamusÀcerebellum)/cerebellum). Drug-free nondepressed OC-checkers showed an 18% reduced brain serotonin transporter availability in the thalamus and hypothalamus, as compared with healthy control subjects (1.3870.19 vs 1.6970.21; po0.001). There was a strong negative correlation between severity of OC symptomatology (Y-BOCS scores) and SERT availability (r ¼ À0.80; po0.001). Moreover, we found a significant positive correlation between illness duration and serotonin transporter availability (r ¼ 0.43; po0.05). This first report of significantly reduced [ 123 I]-b-CIT binding in the thalamus-hypothalamus region in OC-checkers suggests reduced brain serotonin transporter availability, which is more pronounced with increased severity of OC symptomatology and short duration of illness. The results provide direct evidence for an involvement of the serotonergic system in the pathophysiology of OCD.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 68%

[123I]-β-CIT SPECT Imaging Shows Reduced Thalamus–Hypothalamus Serotonin Transporter Availability in 24 Drug-Free Obsessive-Compulsive Checkers

Zitterl

Aigner

Stompe

et al. 2006

Neuropsychopharmacol

View full text Add to dashboard Cite

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“…97 There was no overall reduction in serotonin transporter density in patients with TS. The authors suggest that serotoninergic transmission is a modifying, but not causal, factor in the pathogenesis of tics.…”

Section: Serotoninmentioning

confidence: 93%

“…96 In contrast, other investigators using similar techniques in 10 adult patients with TS have shown no difference in the mean ␤-CIT binding compared with control subjects. 97 Studies evaluating dorsal striatal dopaminergic innervation by use of in vivo measures of vesicular monoamine transporter type 2 (VMAT2) binding with the ligand (+)-alpha-[ 11 C] dihydrotetrabenazine showed no differences between eight subjects with TS and 22 age-compatible normal control subjects. 98 These results do not support the concept of increased striatal innervation, but do not exclude an abnormality in the regulation of dopamine release or reuptake.…”

Section: Dopaminementioning

confidence: 99%

Current issues in Tourette syndrome

Singer

2000

Mov. Disord.

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“…Studies have shown that TS patients who are resistant to neuroleptics show a reduction in tic severity with risperidone, which has combined 5-HT 2 and D 2 antagonism properties (Bruun and Budman, 1996). A negative correlation has been shown between vocal tics and SERT (Heinz et al, 1998). There are few studies on OCD or TS + OCD that clearly delineate the 5-HT abnormalities, and imaging studies have reported inconsistent results.…”

Section: -Ht and Da Relationshipsmentioning

confidence: 99%

Mechanisms of Dopaminergic and Serotonergic Neurotransmission in Tourette Syndrome: Clues from an In Vivo Neurochemistry Study with PET

Wong

Brašić

Singer

et al. 2007

Neuropsychopharmacol

233

172

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Tourette syndrome (TS) is a neuropsychiatric disorder with childhood onset characterized by motor and phonic tics. Obsessivecompulsive disorder (OCD) is often concomitant with TS. Dysfunctional tonic and phasic dopamine (DA) and serotonin (5-HT) metabolism may play a role in the pathophysiology of TS. We simultaneously measured the density, affinity, and brain distribution of dopamine D 2 receptors (D 2 -R's), dopamine transporter binding potential (BP), and amphetamine-induced dopamine release (DA rel ) in 14 adults with TS and 10 normal adult controls. We also measured the brain distribution and BP of serotonin 5-HT 2A receptors (5-HT 2A R), and serotonin transporter (SERT) BP, in 11 subjects with TS and 10 normal control subjects. As compared with controls, DA rel was significantly increased in the ventral striatum among subjects with TS. Adults with TS + OCD exhibited a significant D 2 -R increase in left ventral striatum. SERT BP in midbrain and caudate/putamen was significantly increased in adults with TS (TS + OCD and TS-OCD). In three subjects with TS + OCD, in whom D 2 -R, 5-HT 2A R, and SERT were measured within a 12-month period, there was a weakly significant elevation of DA rel and 5-HT 2A BP, when compared with TS-OCD subjects and normal controls. The current study confirms, with a larger sample size and higher resolution PET scanning, our earlier report that elevated DA rel is a primary defect in TS. The finding of decreased SERT BP, and the possible elevation in 5-HT 2A R in individuals with TS who had increased DA rel , suggest a condition of increased phasic DA rel modulated by low 5-HT in concomitant OCD.

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Tourette's syndrome

Abstract: 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.

Cited by 93 publications

References 7 publications

[123I]-β-CIT SPECT Imaging Shows Reduced Thalamus–Hypothalamus Serotonin Transporter Availability in 24 Drug-Free Obsessive-Compulsive Checkers

[123I]-β-CIT SPECT Imaging Shows Reduced Thalamus–Hypothalamus Serotonin Transporter Availability in 24 Drug-Free Obsessive-Compulsive Checkers

Current issues in Tourette syndrome

Mechanisms of Dopaminergic and Serotonergic Neurotransmission in Tourette Syndrome: Clues from an In Vivo Neurochemistry Study with PET

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