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Striatal presynaptic monoaminergic vesicles are not increased in Tourette’s syndrome

From the Department of Internal Medicine (Drs. Meyer, Bohnen, Minoshima, Koeppe, Kilbourn, Kuhl, and Frey, and K. Wernette), Division of Nuclear Medicine, and the Department of Neurology (Drs. Frey and Albin, and K. Wernette), The University of Michigan Medical School; and Geriatric Research (Dr. Albin), Education and Clinical Center, Veterans Administration Medical Center, Ann Arbor, MI.

Address correspondence and reprint requests to Dr. Roger L. Albin, Neuroscience Building, 1103 E. Huron, Ann Arbor, MI 48104.

BACKGROUND: Abnormal function of striatal dopaminergic synapses is suggested to underlie Tourette’s syndrome (TS).

OBJECTIVE: To determine dorsal striatal dopaminergic innervation in TS. Prior in vitro and in vivo studies of dopamine reuptake transporter binding sites suggest increased striatal dopaminergic innervation in TS.

METHODS: We used in vivo measures of striatal vesicular monoamine transporter type-2 (VMAT2) binding to quantify striatal dopaminergic innervation in TS. Eight TS patients (mean age 30 ± 9 years) and 22 age-comparable normal controls (age 34 ± 8 years) underwent PET imaging with the VMAT2 ligand (+)--[¹¹C]dihydrotetrabenazine (DTBZ). Compartmental modeling was used to quantify blood-to-brain ligand transport and VMAT2 binding site density from the tissue-to-plasma distribution volume (DV) during continuous (+)--[¹¹C]DTBZ infusion. DTBZ DV in dorsal striatal regions was expressed relative to the occipital cortex to estimate relative specific VMAT2 binding (binding potential).

RESULTS: We found no significant differences in VMAT2 binding potential between patients and controls in the caudate nucleus, anterior putamen, or posterior putamen. There were no significant differences in striatal VMAT2 binding between patients with (n = 5) or without (n = 3) features of obsessive-compulsive disorder.

CONCLUSIONS: There is no evidence for increased binding to the VMAT2 in TS striatum and that dorsal striatal dopaminergic innervation density is normal in TS. The previously reported changes in dopamine transporter binding sites may reflect medication effect and/or altered synaptic activity or regulation of dopamine transporter expression in nigrostriatal neurons.

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