1
|
Lower serotonin transporter binding in patients with cervical dystonia is associated with psychiatric symptoms. EJNMMI Res 2017; 7:87. [PMID: 29071431 PMCID: PMC5656503 DOI: 10.1186/s13550-017-0338-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/17/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cervical dystonia (CD) is often accompanied by depressive symptoms, anxiety, and jerks/tremor. The dopamine transporter (DAT) binding is related with both depressive symptoms and jerks/tremor in CD. Serotonergic and dopaminergic systems are closely related. As serotonin is involved in the pathophysiology of psychiatric symptoms and jerks, we expected an altered serotoninergic system in CD. We hypothesized that CD is associated with reduced serotonin transporter (SERT) binding, more specific that SERT binding is lower in CD patients with psychiatric symptoms and/or jerks/tremor compared to those without, and to controls. The balance between SERT and DAT binding can be altered in different CD phenotypes. RESULTS In 23 CD patients and 14 healthy controls, SERT binding in the diencephalon/midbrain was assessed using [123I]FP-CIT SPECT, with a brain-dedicated system. The specific to non-specific binding ratio (binding potential; BPND) to SERT was the main outcome measure. There was a clear trend towards reduced SERT BPND in CD patients with psychiatric symptoms compared to those without (p = 0.05). There was no correlation between SERT binding and dystonia, jerks, or anxiety. There was a significant positive correlation between extrastriatal SERT and striatal DAT BPND in CD patients with jerks, but not in patients without jerks. CONCLUSION CD patients with psychiatric symptoms have lower SERT binding in the midbrain/diencephalon, while dystonia and jerks appear unrelated to SERT binding. The balance between extrastriatal SERT and striatal DAT binding is different in CD with and without jerks.
Collapse
|
2
|
Peall KJ, Ng J, Dy ME, Sharma N, Pope S, Heales S, Friedman JR, Kurian MA. Low CSF 5-HIAA in Myoclonus Dystonia. Mov Disord 2017; 32:1647-1649. [PMID: 28949039 DOI: 10.1002/mds.27117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/03/2017] [Accepted: 06/07/2017] [Indexed: 11/07/2022] Open
Affiliation(s)
- Kathryn J Peall
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, United Kingdom
| | - Joanne Ng
- Developmental Neurosciences, UCL Great Ormond Street-Institute of Child Health, London, United Kingdom
- Department of Neurology, Great Ormond Street Hospital, London, United Kingdom
| | - Marisela E Dy
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, Massachusetts, USA
| | - Nutan Sharma
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, Massachusetts, USA
| | - Simon Pope
- Neurometabolic Unit, The National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Simon Heales
- Neurometabolic Unit, The National Hospital for Neurology and Neurosurgery, London, United Kingdom
- Centre for Translational Omics, UCL Great Ormond Street, Institute of Child Health, London, United Kingdom
| | - Jennifer R Friedman
- Departments of Neurosciences and Pediatrics, UC San Diego School, Rady Children's Hospital and Rady Children's Institute for Genomic Medicine, San Diego, California, USA
| | - Manju A Kurian
- Developmental Neurosciences, UCL Great Ormond Street-Institute of Child Health, London, United Kingdom
- Department of Neurology, Great Ormond Street Hospital, London, United Kingdom
| |
Collapse
|
3
|
Smit M, Bartels AL, van Faassen M, Kuiper A, Niezen-Koning KE, Kema IP, Dierckx RA, de Koning TJ, Tijssen MA. Serotonergic perturbations in dystonia disorders-a systematic review. Neurosci Biobehav Rev 2016; 65:264-75. [PMID: 27073048 DOI: 10.1016/j.neubiorev.2016.03.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/02/2016] [Accepted: 03/22/2016] [Indexed: 11/26/2022]
Abstract
Dystonia is a hyperkinetic movement disorder characterized by sustained or intermittent muscle contractions. Emerging data describe high prevalences of non-motor symptoms, including psychiatric co-morbidity, as part of the phenotype of dystonia. Basal ganglia serotonin and serotonin-dopamine interactions gain attention, as imbalances are known to be involved in extrapyramidal movement and psychiatric disorders. We systematically reviewed the literature for human and animal studies relating to serotonin and its role in dystonia. An association between dystonia and the serotonergic system was reported with decreased levels of 5-hydroxyindolacetic acid, the main metabolite of serotonin. A relation between dystonia and drugs affecting the serotonergic system was described in 89 cases in 49 papers. Psychiatric co-morbidity was frequently described, but likely underestimated as it was not systematically examined. Currently, there are no good (pharmaco)therapeutic options for most forms of dystonia or associated non-motor symptoms. Further research using selective serotonergic drugs in appropriate models of dystonia is required to establish the role of the serotonergic system in dystonia and to guide us to new therapeutic strategies.
Collapse
Affiliation(s)
- M Smit
- University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700, RB Groningen, The Netherlands.
| | - A L Bartels
- University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700, RB Groningen, The Netherlands; Ommelander Hospital Group, Department of Neurology, PO Box 30.000, 9930 RA Delfzijl, The Netherlands.
| | - M van Faassen
- University of Groningen, University Medical Center Groningen, Department of Laboratory Medicine, PO Box 30.001, 9700, RB Groningen, The Netherlands.
| | - A Kuiper
- University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700, RB Groningen, The Netherlands.
| | - K E Niezen-Koning
- University of Groningen, University Medical Center Groningen, Department of Laboratory Medicine, PO Box 30.001, 9700, RB Groningen, The Netherlands.
| | - I P Kema
- University of Groningen, University Medical Center Groningen, Department of Laboratory Medicine, PO Box 30.001, 9700, RB Groningen, The Netherlands.
| | - R A Dierckx
- University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, PO Box 30.001, 9700 RB Groningen, The Netherlands.
| | - T J de Koning
- University of Groningen, University Medical Center Groningen, Department of Genetics, PO Box 30.001, 9700 RB Groningen, The Netherlands.
| | - M A Tijssen
- University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700, RB Groningen, The Netherlands.
| |
Collapse
|
4
|
Abstract
The monoamine neurotransmitter disorders are important genetic syndromes that cause disturbances in catecholamine (dopamine, noradrenaline and adrenaline) and serotonin homeostasis. These disorders result in aberrant monoamine synthesis, metabolism and transport. The clinical phenotypes are predominantly neurological, and symptoms resemble other childhood neurological disorders, such as dystonic or dyskinetic cerebral palsy, hypoxic ischaemic encephalopathy and movement disorders. As a consequence, monoamine neurotransmitter disorders are under-recognized and often misdiagnosed. The diagnosis of monoamine neurotransmitter disorders requires detailed clinical assessment, cerebrospinal fluid neurotransmitter analysis and further supportive diagnostic investigations. Prompt and accurate diagnosis of neurotransmitter disorders is paramount, as many are responsive to treatment. The treatment is usually mechanism-based, with the aim to reverse disturbances of monoamine synthesis and/or metabolism. Therapeutic intervention can lead to complete resolution of motor symptoms in some conditions, and considerably improve quality of life in others. In this Review, we discuss the clinical features, diagnosis and management of monoamine neurotransmitter disorders, and consider novel concepts, the latest advances in research and future prospects for therapy.
Collapse
|
5
|
Genome-wide association study of monoamine metabolite levels in human cerebrospinal fluid. Mol Psychiatry 2014; 19:228-34. [PMID: 23319000 DOI: 10.1038/mp.2012.183] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 11/16/2012] [Accepted: 11/26/2012] [Indexed: 12/16/2022]
Abstract
Studying genetic determinants of intermediate phenotypes is a powerful tool to increase our understanding of genotype-phenotype correlations. Metabolic traits pertinent to the central nervous system (CNS) constitute a potentially informative target for genetic studies of intermediate phenotypes as their genetic underpinnings may elucidate etiological mechanisms. We therefore conducted a genome-wide association study (GWAS) of monoamine metabolite (MM) levels in cerebrospinal fluid (CSF) of 414 human subjects from the general population. In a linear model correcting for covariates, we identified one locus associated with MMs at a genome-wide significant level (standardized β=0.32, P=4.92 × 10(-8)), located 20 kb from SSTR1, a gene involved with brain signal transduction and glutamate receptor signaling. By subsequent whole-genome expression quantitative trait locus (eQTL) analysis, we provide evidence that this variant controls expression of PDE9A (β=0.21; P unadjusted=5.6 × 10(-7); P corrected=0.014), a gene previously implicated in monoaminergic transmission, major depressive disorder and antidepressant response. A post hoc analysis of loci significantly associated with psychiatric disorders suggested that genetic variation at CSMD1, a schizophrenia susceptibility locus, plays a role in the ratio between dopamine and serotonin metabolites in CSF. The presented DNA and mRNA analyses yielded genome-wide and suggestive associations in biologically plausible genes, two of which encode proteins involved with glutamate receptor functionality. These findings will hopefully contribute to an exploration of the functional impact of the highlighted genes on monoaminergic transmission and neuropsychiatric phenotypes.
Collapse
|
6
|
The monoamine neurotransmitter disorders: an expanding range of neurological syndromes. Lancet Neurol 2011; 10:721-33. [DOI: 10.1016/s1474-4422(11)70141-7] [Citation(s) in RCA: 239] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
7
|
De Grandis E, Serrano M, Pérez-Dueñas B, Ormazábal A, Montero R, Veneselli E, Pineda M, González V, Sanmartí F, Fons C, Sans A, Cormand B, Puelles L, Alonso A, Campistol J, Artuch R, García-Cazorla A. Cerebrospinal fluid alterations of the serotonin product, 5-hydroxyindolacetic acid, in neurological disorders. J Inherit Metab Dis 2010; 33:803-9. [PMID: 20852934 DOI: 10.1007/s10545-010-9200-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 07/29/2010] [Accepted: 08/24/2010] [Indexed: 11/30/2022]
Abstract
Although patients with low cerebrospinal fluid (CSF) serotonin metabolite levels have been reported, inborn errors of the rate-limiting enzyme of serotonin synthesis (tryptophan hydroxylase, TPH) have not been described so far. In this study we aimed to evaluate CSF alterations of the serotonin metabolite 5-hydroxyindolacetic acid (5-HIAA) in patients with neurological disorders and to explore a possible TPH deficiency in some of them. A total of 606 patients (286 males, 320 females, mean age 4 years and 6 months, SD 5 years and 7 months) underwent CSF analysis of neurotransmitter metabolites by reverse phase high performance liquid chromatography. Results were compared with values established in a control population. Patients' medical records were reviewed to determine diagnosis and clinical features. A primary defect of biogenic amines was genetically investigated in indicated patients. Low 5-HIAA was seen in 19.3%. Of these, 22.2% showed inborn errors of metabolism (mitochondrial disorders being the most frequent at 10.2% of low 5-HIAA patients) and neurogenetic conditions. Other relatively frequent conditions were pontocerebellar hypoplasia (4.3%), Rett syndrome (4.3%), and among congenital nonetiologically determined conditions, epilepsy including epileptic encephalopathies (26.4%), leukodystrophies (6.8%), and neuropsychiatric disturbances (4.2%). Mutational analysis of the TPH2 gene, performed in five candidate patients, was negative. Although frequency of secondary alteration of 5-HIAA was relatively high in patients with neurological disorders, this finding was more frequently associated with some neurometabolic disorders, epileptic encephalopathies, and neuropsychiatric disturbances. No inborn errors of TPH were found. Due to serotonin's neurotrophic role and to ameliorate symptoms, a supplementary treatment with 5-hydroxytriptophan would seem advisable in these patients.
Collapse
Affiliation(s)
- Elisa De Grandis
- Neurology Department, Hospital Sant Joan de Deu, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Belenky VV, Golovkin VI, Koroleva EM, Verbitskaya EV, Klitsenko OA, Stanzhevsky AA, Tyutin LA. Turnover of catecholamines in torsion dystonia. NEUROCHEM J+ 2010. [DOI: 10.1134/s1819712410010113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
9
|
García-Cazorla A, Serrano M, Pérez-Dueñas B, González V, Ormazábal A, Pineda M, Fernández-Alvarez E, Campistol JMD, Artuch RMD. Secondary abnormalities of neurotransmitters in infants with neurological disorders. Dev Med Child Neurol 2007; 49:740-4. [PMID: 17880642 DOI: 10.1111/j.1469-8749.2007.00740.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Neurotransmitters are essential in young children for differentiation and neuronal growth of the developing nervous system. We aimed to identify possible factors related to secondary neurotransmitter abnormalities in pediatric patients with neurological disorders. We analyzed cerebrospinal fluid (CSF) and biogenic amine metabolites in 56 infants (33 males, 23 females; mean age 5.8mo [SD 4.1mo] range 1d-1y) with neurological disorders whose aetiology was initially unknown. Patients were classified into three clinical phenotypes: epileptic encephalopathy, severe motor impairment, and non-specific manifestations. All patients showed normal results for screening of inborn errors of metabolism. We report clinical, neuroimaging, and follow-up data. Among the patients studied, 10 had low homovanillic acid (HVA) levels and in four patients, 5-hydroxyindoleacetic acid (5-HIAA) was also reduced. Patients with neonatal onset had significantly lower levels of HVA than a comparison group. HVA deficiency was also associated with severe motor impairment and the final diagnosis related to neurodegenerative disorders. 5-HIAA values tended to be decreased in patients with brain cortical atrophy. The possibility of treating patients with L-Dopa and 5-hydroxytryptophan, in order to improve their neurological function and maturation, may be considered.
Collapse
Affiliation(s)
- A García-Cazorla
- Neurology Department, Hospital Sant Joan de Déu, University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Evans AH, Costa DC, Gacinovic S, Katzenschlager R, O'sullivan JD, Heales S, Lee P, Lees AJ. L-dopa-responsive Parkinson's syndrome in association with phenylketonuria: In vivo dopamine transporter and D2 receptor findings. Mov Disord 2004; 19:1232-6. [PMID: 15390012 DOI: 10.1002/mds.20146] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Reports of parkinsonism in phenylketonuria are exceedingly rare. We report on a patient who had received a delayed diagnosis of phenylketonuria as an infant and subsequently developed levodopa-responsive parkinsonism at the age of 33. Single-photon emission computed tomography (SPECT) using (123)I-FP-CIT ([(123))I]-2 beta-carbomethoxy-3beta-(-4-iodophenyl)-N-(3-fluoropropyl)-nortropane) used to measure dopamine transporter levels on two occasions, 7 and 9 years after the onset of neurological symptoms, were normal. Iodine-123-iodo-lisuride SPECT (IBZM) imaging, however, showed reduced caudate over putamen binding. This combination of imaging findings indicates a possible upregulation of postsynaptic D2 receptors in the context of intact presynaptic dopamine nerve terminal density.
Collapse
Affiliation(s)
- Andrew H Evans
- Reta Lila Weston Institute of Neurological Studies, University College London, United Kingdom
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Hamann M, Richter A. Striatal increase of extracellular dopamine levels during dystonic episodes in a genetic model of paroxysmal dyskinesia. Neurobiol Dis 2004; 16:78-84. [PMID: 15207264 DOI: 10.1016/j.nbd.2004.01.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2003] [Revised: 12/17/2003] [Accepted: 01/14/2004] [Indexed: 11/30/2022] Open
Abstract
In vivo microdialysis was used to examine the levels of dopamine, serotonin, and their metabolites dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA), and 5-hydroxyindoleacetic acid (5-HIAA) in the striatum of dt(sz) mutant hamsters, an animal model of paroxysmal dyskinesia, in which stress can precipitate dystonic episodes. Measurements were made under three different conditions in each animal: (1) at baseline in the absence of abnormal involuntary movements, (2) during an episode of paroxysmal dystonia precipitated by handling, and (3) during the recovery (postdystonic) period. In comparison to nondystonic control hamsters, which were treated in the same manner as dystonic animals, no changes could be detected under basal conditions, although the levels of DOPAC and HVA tended to be higher in mutant hamsters. Significantly elevated striatal levels of dopamine and DOPAC became evident during the period of stress-induced dystonic attacks in mutant hamsters. During dystonic episodes, dopamine levels were approximately 6.5-fold higher (followed by a 2.5-fold increase of DOPAC) in dt(sz) hamsters than in normal controls. Before the disappearance of dystonia, the levels of dopamine returned to basal concentrations in mutant hamsters. Consistent with previous pharmacologic findings, paroxysmal dystonia in mutant hamsters is associated with temporary increases of extracellular dopamine levels in the striatum.
Collapse
Affiliation(s)
- Melanie Hamann
- Institute of Pharmacology and Toxicology, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | | |
Collapse
|