Elsevier

Biological Psychiatry

Volume 55, Issue 10, 15 May 2004, Pages 1041-1045
Biological Psychiatry

Original article
Low level of dopaminergic D2 receptor binding in obsessive-compulsive disorder

https://doi.org/10.1016/j.biopsych.2004.01.023Get rights and content

Abstract

Background

Despite growing evidence for involvement of the dopaminergic system in obsessive-compulsive disorder (OCD), the functional anatomy of the dopaminergic system in the basal ganglia has been investigated sparsely.

Methods

Dopamine D2 receptor binding was assessed in 10 medication-free OCD patients and 10 healthy control subjects, matched for age, gender, and handedness. The binding potential was measured with single photon emission computerized tomography (SPECT) and infusion of the D2 receptor radiotracer [123I] iodobenzamide. With magnetic resonance imaging as reference, regions of interest (caudate and putamen) were delineated for each hemisphere and coregistered with the corresponding SPECT scans.

Results

Dopamine D2 receptor binding in the left caudate nucleus was significantly lower in the patients with OCD than in healthy control subjects [F(1,18) = 7.0, p = .016]. In addition, an interhemispheric difference was observed in the patient sample. Both the D2 receptor binding potential (df = 9, p = .012), and the volume (df = 9, p = .029) of the left caudate nucleus were statistically significantly reduced relative to the right caudate nucleus.

Conclusions

This study provides in vivo evidence for abnormalities in the binding potential of the dopamine D2 receptor, which suggest the direct involvement of the dopaminergic system in the pathophysiology of OCD.

Section snippets

Methods and materials

The subjects in this study were 10 patients with OCD and 10 healthy control subjects, who gave written informed consent for participation in this study, which had been approved by the University of Utrecht Medical Ethical Review committee (Utrecht, The Netherlands). The Mini-International Neuropsychiatric Interview was used to ascertain that patients met DSM-IV criteria for the primary OCD diagnosis and that healthy control subjects were free of psychiatric diagnoses (Sheehan et al 1998). All

Study sample

Clinical characteristics of OCD patients and dopamine D2 receptor phenotypes are shown in Table 1. Patients had a Y-BOCS score (mean ± SD) of 25.9 ± 6.5 and a HAM-D score of 12.3 ± 4.5. Three of 10 patients had a first-degree relative with OCD (patients 1, 4, and 5), two had a first-degree relative with major depressive disorder (patients 3 and 9), and five had no familial psychiatric morbidity. Except for two patients, who have had a comorbid single episode of major depressive disorder

Discussion

The major finding of this study is that patients with OCD have lower dopamine D2 binding ratios in the left caudate nucleus relative to control subjects. We also observed lower D2 binding ratios in and a reduced volume of the left caudate nucleus compared with the right caudate nucleus in patients with OCD. Although our results should be considered preliminary owing to the small sample size, this report is the first to demonstrate in vivo dopamine D2 changes in patients with OCD.

It is not

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