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Dopaminergic Disturbances in Tourette Syndrome: An Integrative Account
Tiago V Maia1, Vasco A Conceição1
1Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Biological Psychiatry
|April 17, 2018
Summary
Tourette syndrome (TS) may stem from dopaminergic hyperinnervation, leading to increased dopamine levels. Effective TS medications target these elevated dopamine signals, supporting this hypothesis.
Area of Science:
- Neuroscience
- Neuropharmacology
- Genetics
Background:
- Tourette syndrome (TS) is linked to dopamine system dysfunction, but specific mechanisms are debated.
- Current hypotheses include dopamine receptor supersensitivity, transporter issues, presynaptic dysfunction, and hyperinnervation.
Purpose of the Study:
- To review neuroimaging evidence for dopaminergic disturbances in Tourette syndrome.
- To evaluate the validity of existing hypotheses and propose a unifying explanation.
Main Methods:
- Systematic review of positron emission tomography (PET) and single-photon emission computerized tomography (SPECT) studies in TS.
- Analysis of evidence supporting and contradicting existing dopaminergic hypotheses in TS.
Main Results:
- Evidence contradicts hypotheses of dopamine receptor supersensitivity and overactive transporters.
- The dopaminergic hyperinnervation hypothesis offers a parsimonious explanation for diverse neuroimaging findings in TS.
- Increased tonic and phasic dopamine, resulting from hyperinnervation, are mechanistically linked to tic expression and learning.
Conclusions:
- Dopaminergic hyperinnervation is a unifying hypothesis for TS pathophysiology.
- Effective TS medications reduce tonic and/or phasic dopamine signaling, supporting the proposed mechanism.
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