Enhanced dopamine transporter density in psychotropic-naive patients with obsessive-compulsive disorder shown by [¹²³I]β-CIT SPECT

Objective: The authors examine the functional anatomy of serotonergic and dopaminergic systems in obsessive-compulsive disorder in psychotropic-naive patients without comorbidity. Method: [¹²³I]β-CIT binding patterns for dopamine and serotonin transporters in the brain were measured in 15 psychotropic-naive adult outpatients with OCD (no comorbidity) and in 15 pairwise-matched healthy subjects. Volumes of interest were constructed on magnetic resonance imaging scans and coregistered with single photon emission computed tomography scans. Binding ratios were compared, and possible correlations between binding patterns and obsessive-compulsive symptoms were assessed. Results: There were significant differences between patients and healthy subjects in the [¹²³I]β-CIT binding pattern for dopamine transporter in the left caudate and left putamen. Patients had higher binding ratios than healthy subjects. No differences were found in the less specific [¹²³I]β-CIT binding pattern for serotonin transporters in the selected volumes of interest. Hemispheric within-group comparisons revealed no asymmetry effects. Conclusions: The results of our study provide direct evidence for an involvement of the dopaminergic system in the pathophysiology of OCD.