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

Evelien Zoons, Marina A. J. Tijssen, Yasmine E. M. Dreissen, Marenka Smit, Jan Booij*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

31 Downloads (Pure)

Abstract

Purpose: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(2/3)receptor (D2/3R), dopamine transporter (DAT) and serotonin transporter (SERT) binding potential (BPND) after a six-week treatment course with escitalopram or placebo.Methods: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.Results:In both patients treated with escitalopram and placebo there were no significant differences after treatment in SERT, DAT or D2/3R BPND. Comparing scans after treatment with escitalopram (n = 8) to placebo (n = 8) showed a trend (p= 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.Conclusion: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.

Original languageEnglish
Article number880
Number of pages11
JournalBiomolecules
Volume10
Issue number6
DOIs
Publication statusPublished - Jun-2020

Keywords

  • cervical dystonia
  • single-photon emission computed tomography (SPECT)
  • dopamine serotonin
  • escitalopram
  • MAJOR DEPRESSIVE DISORDER
  • TRANSPORTER OCCUPANCY
  • I-123-FP-CIT SPECT
  • BINDING
  • HEALTHY
  • RELEASE
  • BRAIN
  • PAROXETINE
  • THALAMUS
  • RECEPTOR

Cite this