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Altered serotonin transporter availability in patients with multiple sclerosis.

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Brain serotonin transporter (SERT) availability is altered in multiple sclerosis (MS) patients, particularly in regions linked to mood and fatigue. These changes in serotonergic neurotransmission may contribute to psychiatric symptoms in MS.

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Area of Science:

  • Neuroscience
  • Immunology
  • Radiology

Background:

  • Central nervous system (CNS) modulation of the immune system may involve brain serotonin transporters (SERT).
  • SERT regulation may be disrupted in CNS disorders like multiple sclerosis (MS).
  • Central serotonergic mechanisms in MS have not been previously studied using in vivo imaging.

Purpose of the Study:

  • To assess serotonin transporter (SERT) availability in antidepressant-naive patients with multiple sclerosis (MS).
  • Utilize Positron Emission Tomography (PET) imaging to quantify SERT availability in the brain.

Main Methods:

  • PET imaging with the SERT-selective marker [(11)C]DASB was performed on 23 MS patients and 22 healthy volunteers.
  • Distribution volume ratios were determined to quantify SERT availability.
  • Clinical assessments included the expanded disability status scale, MS fatigue scale (WEIMuS), and Beck Depression Inventory (BDI).

Main Results:

  • MS patients exhibited lower SERT availability in the cingulate cortex, thalamus, and insula, with increased availability in the orbitofrontal cortex.
  • Relapsing/remitting MS patients showed a trend towards lower hippocampal SERT, while primary progressive MS patients had increased prefrontal SERT.
  • Positive correlations were found between insular SERT availability and depression (BDI) and fatigue (WEIMuS) scores.

Conclusions:

  • Serotonergic neurotransmission is altered in limbic, paralimbic, and frontal cortical regions in MS patients.
  • These alterations in serotonergic pathways likely contribute to the psychiatric symptoms observed in MS.
  • In vivo PET imaging reveals significant changes in brain SERT availability associated with MS.