The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects: A Double-Blind Placebo-Controlled Trial
<i>Purpose:</i> The pathophysiology of cervical dystonia (CD) is thought to be related to changes in dopamine and serotonin levels in the brain. We performed a double-blind trial with escitalopram (selective serotonin reuptake inhibitor; SSRI) in patients with CD. Here, we report on chan...
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| Format: | Article |
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MDPI AG
2020-06-01
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| Series: | Biomolecules |
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| Online Access: | https://www.mdpi.com/2218-273X/10/6/880 |
| _version_ | 1797565896450899968 |
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| author | Evelien Zoons Marina A.J. Tijssen Yasmine E.M. Dreissen Marenka Smit Jan Booij |
| author_facet | Evelien Zoons Marina A.J. Tijssen Yasmine E.M. Dreissen Marenka Smit Jan Booij |
| author_sort | Evelien Zoons |
| collection | DOAJ |
| description | <i>Purpose:</i> The pathophysiology of cervical dystonia (CD) is thought to be related to changes in dopamine and serotonin levels in the brain. We performed a double-blind trial with escitalopram (selective serotonin reuptake inhibitor; SSRI) in patients with CD. Here, we report on changes in dopamine D<sub>2/3</sub> receptor (D2/3R), dopamine transporter (DAT) and serotonin transporter (SERT) binding potential (BP<sub>ND</sub>) after a six-week treatment course with escitalopram or placebo. <i>Methods:</i> CD patients had [123I]FP-CIT SPECT (I-123 fluoropropyl carbomethoxy-3 beta-(4-iodophenyltropane) single-photon emission computed tomography) scans, to quantify extrastriatal SERT and striatal DAT, and [123I]IBZM SPECT (I-123 iodobenzamide SPECT) scans to quantify striatal D2/3R BPND before and after six weeks of treatment with either escitalopram or placebo. Treatment effect was evaluated with the Clinical Global Impression scale for dystonia, jerks and psychiatric symptoms, both by physicians and patients. <i>Results:</i> In both patients treated with escitalopram and placebo there were no significant differences after treatment in SERT, DAT or D2/3R BP<sub>ND</sub>. Comparing scans after treatment with escitalopram (n = 8) to placebo (n = 8) showed a trend (<i>p</i> = 0.13) towards lower extrastriatal SERT BPND in the SSRI group (median SERT occupancy of 64.6%). After treatment with escitalopram, patients who reported a positive effect on dystonia or psychiatric symptoms had significantly higher SERT occupancy compared to patients who did not experience an effect. <i>Conclusion:</i> Higher extrastriatal SERT occupancy after treatment with escitalopram is associated with a trend towards a positive subjective effect on dystonia and psychiatric symptoms in CD patients. |
| first_indexed | 2024-03-10T19:18:26Z |
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| id | doaj.art-ec056cba95344628ab075f7dac3c7832 |
| institution | Directory Open Access Journal |
| issn | 2218-273X |
| language | English |
| last_indexed | 2024-03-10T19:18:26Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomolecules |
| spelling | doaj.art-ec056cba95344628ab075f7dac3c78322023-11-20T03:12:06ZengMDPI AGBiomolecules2218-273X2020-06-0110688010.3390/biom10060880The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects: A Double-Blind Placebo-Controlled TrialEvelien Zoons0Marina A.J. Tijssen1Yasmine E.M. Dreissen2Marenka Smit3Jan Booij4Department of Neurology, Zaans Medisch Centrum, 1502 DV Zaandam, The NetherlandsDepartment of Neurology, University Medical Centre, 9713 GZ Groningen, The NetherlandsDepartment of Neurosurgery, Amsterdam University Medical Centre, Location Academic Medical Centre, 1100 DD Amsterdam, The NetherlandsDepartment of Neurology, University Medical Centre, 9713 GZ Groningen, The NetherlandsDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, Location Academic Medical Centre, 1100 DD Amsterdam, The Netherlands<i>Purpose:</i> The pathophysiology of cervical dystonia (CD) is thought to be related to changes in dopamine and serotonin levels in the brain. We performed a double-blind trial with escitalopram (selective serotonin reuptake inhibitor; SSRI) in patients with CD. Here, we report on changes in dopamine D<sub>2/3</sub> receptor (D2/3R), dopamine transporter (DAT) and serotonin transporter (SERT) binding potential (BP<sub>ND</sub>) after a six-week treatment course with escitalopram or placebo. <i>Methods:</i> CD patients had [123I]FP-CIT SPECT (I-123 fluoropropyl carbomethoxy-3 beta-(4-iodophenyltropane) single-photon emission computed tomography) scans, to quantify extrastriatal SERT and striatal DAT, and [123I]IBZM SPECT (I-123 iodobenzamide SPECT) scans to quantify striatal D2/3R BPND before and after six weeks of treatment with either escitalopram or placebo. Treatment effect was evaluated with the Clinical Global Impression scale for dystonia, jerks and psychiatric symptoms, both by physicians and patients. <i>Results:</i> In both patients treated with escitalopram and placebo there were no significant differences after treatment in SERT, DAT or D2/3R BP<sub>ND</sub>. Comparing scans after treatment with escitalopram (n = 8) to placebo (n = 8) showed a trend (<i>p</i> = 0.13) towards lower extrastriatal SERT BPND in the SSRI group (median SERT occupancy of 64.6%). After treatment with escitalopram, patients who reported a positive effect on dystonia or psychiatric symptoms had significantly higher SERT occupancy compared to patients who did not experience an effect. <i>Conclusion:</i> Higher extrastriatal SERT occupancy after treatment with escitalopram is associated with a trend towards a positive subjective effect on dystonia and psychiatric symptoms in CD patients.https://www.mdpi.com/2218-273X/10/6/880cervical dystoniasingle-photon emission computed tomography (SPECT)dopamine serotoninescitalopram |
| spellingShingle | Evelien Zoons Marina A.J. Tijssen Yasmine E.M. Dreissen Marenka Smit Jan Booij The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects: A Double-Blind Placebo-Controlled Trial Biomolecules cervical dystonia single-photon emission computed tomography (SPECT) dopamine serotonin escitalopram |
| title | The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects: A Double-Blind Placebo-Controlled Trial |
| title_full | The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects: A Double-Blind Placebo-Controlled Trial |
| title_fullStr | The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects: A Double-Blind Placebo-Controlled Trial |
| title_full_unstemmed | The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects: A Double-Blind Placebo-Controlled Trial |
| title_short | The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects: A Double-Blind Placebo-Controlled Trial |
| title_sort | effect of escitalopram on central serotonergic and dopaminergic systems in patients with cervical dystonia and its relationship with clinical treatment effects a double blind placebo controlled trial |
| topic | cervical dystonia single-photon emission computed tomography (SPECT) dopamine serotonin escitalopram |
| url | https://www.mdpi.com/2218-273X/10/6/880 |
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