Brain regional α-[11C]methyl-L-tryptophan trapping in medication-free patients with obsessive-compulsive disorder

Alexandre Berney, Marco Leyton, Paul Gravel, Igor Sibon, Debbie Sookman, Pedro Rosa Neto, Mirko Diksic, Akio Nakai, Gilbert Pinard, Christo Todorov, Hidehiko Okazawa, Pierre Blier, Thomas E Nordahl, Chawki Benkelfat

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Context: The hypothesis of a serotonin (5-hydroxytryptamine [5-HT]) dysfunction in obsessive-compulsive disorder (OCD) stems largely from the clinical efficacy of 5-HT reuptake inhibitors. Serotonergic abnormalities in the unmedicated symptomatic state, however, remain to be fully characterized. Objective: To investigate brain regional 5-HT synthesis, as indexed by positron emission tomography and the α-[11C]methyl-L-tryptophan trapping constant (K*), in treatment-free adults meeting criteria for OCD. Design: Between-group comparison. Setting: Department of Psychiatry and Montreal Neurological Institute, McGill University, and Department of Psychology, McGill University Health Centre, Quebec, Canada. Participants: Twenty-one medication-free patients with OCD (15 men with a mean [SD] age of 33.2 [9.3] years and 6 women with a mean [SD] age of 35.8 [7.1] years) and 21 healthy controls matched for age and sex (15 men with a mean [SD] age of 32.9 [10.1] years and 6 women with a mean [SD] age of 36.5.5 [8.6] years). Main Outcome Measure: The α-[11C]methyl-Ltryptophan brain trapping constant K*, which was analyzed with Statistical Parametric Mapping (SPM8) and with proportional normalization (extent threshold of 100 voxels with a peak threshold of P≤.005). Results: Compared with healthy controls, the patients with OCD exhibited significantly greater α-[11C]methyl-L- tryptophan trapping in the right hippocampus and left temporal gyrus (Brodmann area 20). In the larger subsample of all men, these same differences were also evident, as well as higher K* values in the caudate nucleus. Individual differences in symptom severity correlated positively with K* values sampled from the caudate and temporal lobe of the patients with OCD, respectively. There were no regions where the patients exhibited abnormally low K* values. Volumetric analyses found no morphometric alterations that would account for the group differences. Conclusion: The results support previous reports of greater striatal and temporal lobe activity in patients with OCD than in healthy controls and suggest that these disturbances include a serotonergic component. Previously reported glucose metabolic disturbances in OCD involving the orbitofrontal and cingulate cortices, in comparison, might reflect postsynaptic changes in the serotonergic system.

Original languageEnglish (US)
Pages (from-to)732-741
Number of pages10
JournalArchives of General Psychiatry
Volume68
Issue number7
DOIs
StatePublished - Jul 2011

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    Berney, A., Leyton, M., Gravel, P., Sibon, I., Sookman, D., Rosa Neto, P., Diksic, M., Nakai, A., Pinard, G., Todorov, C., Okazawa, H., Blier, P., Nordahl, T. E., & Benkelfat, C. (2011). Brain regional α-[11C]methyl-L-tryptophan trapping in medication-free patients with obsessive-compulsive disorder. Archives of General Psychiatry, 68(7), 732-741. https://doi.org/10.1001/archgenpsychiatry.2011.16