Deep Brain Stimulation Induces Striatal Dopamine Release in Obsessive-Compulsive Disorder
Deep Brain Stimulation Induces Striatal Dopamine Release in Obsessive-Compulsive Disorder
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DOI：
10.1016/j.biopsych.2013.06.021
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发表时间：
2014-04-15
影响因子：
10.6
通讯作者：
Denys, Damiaan
中科院分区：
文献类型：
--
作者：
Figee, Martijn;de Koning, Pelle;Denys, Damiaan
背景：强迫症是一种与多巴胺能神经传递功能障碍有关的慢性精神疾病。靶向中脑核（NAc）的脑深部电刺激（DBS）最近已成为治疗难治性强迫症的有效治疗方法，但其对多巴胺能传递的影响尚不清楚。我们用[I-123]碘苯甲酰胺测量了15例患者的NAc DBS对纹状体多巴胺D-2/3受体可用性的影响（[I-123] IBZM）单光子发射计算机断层扫描。我们相关的变化[I-123] IBZM结合电位（BP）与血浆水平的高香草酸（HVA）和临床symptoms.Results：急性（1小时）和慢性（1年）DBS减少纹状体[I-123] IBZM BP与非刺激条件下的壳核。刺激1小时后观察到BP降低，慢性刺激与同时发生的HVA血浆升高相关，这意味着DBS诱导的多巴胺释放。血压下降的区域直接周围的电极显着相关的临床症状的变化（45%的症状减少）。结论：NAC DBS诱导纹状体多巴胺的释放，这是与增加HVA血浆水平和改善临床症状，这表明DBS可能会弥补一个有缺陷的多巴胺能系统。
Background: Obsessive-compulsive disorder is a chronic psychiatric disorder related to dysfunctional dopaminergic neurotransmission. Deep brain stimulation (DBS) targeted at the nucleus accumbens (NAc) has recently become an effective treatment for therapy-refractory obsessive-compulsive disorder, but its effect on dopaminergic transmission is unknown.Methods: We measured the effects of NAc DBS in 15 patients on the dopamine D-2/3 receptor availability in the striatum with [I-123] iodobenzamide ([I-123] IBZM) single photon emission computed tomography. We correlated changes in [I-123] IBZM binding potential (BP) with plasma levels of homovanillic acid (HVA) and clinical symptoms.Results: Acute (1-hour) and chronic (1-year) DBS decreased striatal [I-123] IBZM BP compared with the nonstimulated condition in the putamen. BP decreases were observed after 1 hour of stimulation, and chronic stimulation was related to concurrent HVA plasma elevations, implying DBS-induced dopamine release. BP decreases in the area directly surrounding the electrodes were significantly correlated with changes in clinical symptoms (45% symptom decrease).Conclusions: NAc DBS induced striatal dopamine release, which was associated with increased HVA plasma levels and improved clinical symptoms, suggesting that DBS may compensate for a defective dopaminergic system.