The relationship between the dopaminergic system and depressive symptoms in cervical dystonia

• Published in: European journal of nuclear medicine and molecular imaging Vol. 44; no. 8; pp. 1375 - 1382
• Main Authors: Zoons, E., Tijssen, M. A. J., Dreissen, Y. E. M., Speelman, J. D., Smit, M., Booij, J.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2017; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Binding; Cadmium; Cardiology; Case-Control Studies; Correlation analysis; Criteria; Depression - complications; Dopamine; Dopamine - metabolism; Dopamine D2 receptors; Dopamine transporter; Dystonia; Female; Humans; Imaging; Male; Medicine; Medicine & Public Health; Mental depression; Middle Aged; Motor task performance; Myoclonus; Neostriatum; Neuromuscular diseases; Neuropsychology; Nuclear Medicine; Oncology; Original; Original Article; Orthopedics; Patients; Radiology; Receptors, Dopamine D2 - metabolism; Receptors, Dopamine D3 - metabolism; Single photon emission computed tomography; Tomography, Emission-Computed, Single-Photon; Torticollis - complications; Torticollis - diagnostic imaging; Torticollis - metabolism; Torticollis - psychology; Tremor; Dopamine transporter (DAT); Dopamine D2/3 receptor; Depression; Cervical dystonia; SPECT
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-017-3664-x

Purpose Cervical dystonia (CD) is associated with tremor/jerks (50%) and psychiatric complaints (17–70%). The dopaminergic system has been implicated in the pathophysiology of CD in animal and imaging studies. Dopamine may be related to the motor as well as non-motor symptoms of CD. CD is associated with reduced striatal dopamine D 2/3 (D2/3) receptor and increased dopamine transporter (DAT) binding. There are differences in the dopamine system between CD patients with and without jerks/tremor and psychiatric symptoms. Methods Patients with CD and healthy controls underwent neurological and psychiatric examinations. Striatal DAT and D2/3 receptor binding were assessed using [ 123 I]FP-CIT and [ 123 I]IBZM SPECT, respectively. The ratio of specific striatal to non-specific binding (binding potential; BP ND ) was the outcome measure. Results Twenty-seven patients with CD and 15 matched controls were included. Nineteen percent of patients fulfilled the criteria for a depression. Striatal DAT BP ND was significantly lower in depressed versus non-depressed CD patients. Higher DAT BP ND correlated significantly with higher scores on the Unified Myoclonus Rating Scale (UMRS). The striatal D2/3 receptor BP ND in CD patients showed a trend towards lower binding compared to controls. The D2/3 BP ND was significantly lower in depressed versus non-depressed CD patients. A significant correlation between DAT and D2/3R BP ND was found in both in patients and controls. Conclusions Alterations of striatal DAT and D2/3 receptor binding in CD patients are related mainly to depression. DAT BP ND correlates significantly with scores on the UMRS, suggesting a role for dopamine in the pathophysiology of tremor/jerks in CD.