Deep brain stimulation induces striatal dopamine release in obsessive-compulsive disorder.

Abstract

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 D2/3 receptor availability in the striatum with [(123)I]iodobenzamide ([(123)I]IBZM) single photon emission computed tomography. We correlated changes in [(123)I]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 [(123)I]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.

• Authors: Martijn Figee, Pelle de Koning, Sanne Klaassen, Nienke Vulink, Mariska Mantione, Pepijn van den Munckhof, Richard Schuurman, Guido van Wingen, Thérèse van Amelsvoort, Jan Booij, Damiaan Denys
• Journal: Biological psychiatry (Biol Psychiatry) Vol. 75 Issue 8 Pg. 647-52 (Apr 15 2014) ISSN: 1873-2402 [Electronic] United States
• PMID: 23938318 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Chemical References

• Iodobenzenes
• Receptors, Dopamine D2
• Receptors, Dopamine D3
• idobenzamide
• Dopamine
• Homovanillic Acid

Topics

• Adult
• Corpus Striatum (diagnostic imaging, physiopathology)
• Deep Brain Stimulation (methods)
• Dopamine (metabolism)
• Female
• Homovanillic Acid (blood)
• Humans
• Iodobenzenes
• Magnetic Resonance Imaging
• Male
• Obsessive-Compulsive Disorder (diagnostic imaging, physiopathology, therapy)
• Putamen (diagnostic imaging, metabolism)
• Receptors, Dopamine D2 (metabolism)
• Receptors, Dopamine D3 (metabolism)
• Severity of Illness Index
• Time Factors
• Tomography, Emission-Computed, Single-Photon
• Treatment Outcome