Article

Journal of Neural Transmission

, Volume 114, Issue 12, pp 1603-1609

Reduced availability of serotonin transporters in obsessive-compulsive disorder correlates with symptom severity – a [11C]DASB PET study

  • M. ReimoldAffiliated withDepartment of Nuclear Medicine, University of Tübingen
  • , M. N. SmolkaAffiliated withDepartment of Addictive Behavior and Addiction Research, Central Institute of Mental Health, University of Heidelberg
  • , A. ZimmerAffiliated withDepartment of Addictive Behavior and Addiction Research, Central Institute of Mental Health, University of Heidelberg
  • , A. BatraAffiliated withDepartment of Psychiatry, University of Tübingen
  • , A. KnobelAffiliated withDepartment of Psychiatry and Psychotherapy, Charité – University Medical Center, CCM
  • , C. SolbachAffiliated withDepartment of Radiopharmacy, University of Tübingen
  • , A. MundtAffiliated withDepartment of Psychiatry and Psychotherapy, Charité – University Medical Center, CCM
  • , H. U. SmoltczykAffiliated withDepartment of Psychiatry, University of Tübingen
  • , D. GoldmanAffiliated withNational Institute of Alcohol Abuse and Alcoholism, NIH
    • , K. MannAffiliated withDepartment of Addictive Behavior and Addiction Research, Central Institute of Mental Health, University of Heidelberg
    • , G. ReischlAffiliated withDepartment of Radiopharmacy, University of Tübingen
    • , H.-J. MachullaAffiliated withDepartment of Radiopharmacy, University of Tübingen
    • , R. BaresAffiliated withDepartment of Nuclear Medicine, University of Tübingen
    • , A. HeinzAffiliated withDepartment of Addictive Behavior and Addiction Research, Central Institute of Mental Health, University of HeidelbergDepartment of Psychiatry and Psychotherapy, Charité – University Medical Center, CCM

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Summary

Reduced availability of brainstem serotonin transporters (5-HTT) has been observed in vivo in obsessive-compulsive disorder (OCD). However, results vary and may be influenced by competition with endogenous serotonin. Using positron emission tomography (PET) and [11C]DASB, a specific 5-HTT ligand that showed no competition with serotonin for 5-HTT binding in vitro, we tested the hypothesis that 5-HTT availability is reduced in OCD patients and correlated with OCD severity.

Methods. 5-HTT availability in the thalamus and the midbrain was measured in nine drug-free OCD patients and compared with 19 healthy controls, matched for the individual combination of 5-HTT genotype, gender and smoking status. OCD severity was assessed with the Yale-Brown obsessive compulsive scale (Y-BOCS).

Results. 5-HTT availability was significantly reduced in the thalamus and midbrain of OCD patients. Age and 5-HTT in the thalamus explained 83% of OCD severity in patients that were drug-free for at least 1 year.

Conclusion. This PET study confirms a central role of the serotonergic system, particularly the thalamus in the pathogenesis of obsessive compulsive disorder.

Keywords: 5-HTT; OCD; SERT; 5-HTTLPR; thalamus