Elevated hypothalamic/midbrain serotonin (monoamine) transporter availability in depressive drug-naive children and adolescents

Abstract

Cumulative data suggest depression in adulthood being connected to reduced availability of brain serotonin while the role of dopamine remains less specific. Prospective studies have shown a continuity of depressive episodes from childhood to adulthood, combined with poor social function and excess mortality. The object of this study was to examine whether alterations in brain serotonin and/or dopamine transporter levels are already present in depressive children and adolescents. We examined 41 drug-naive patients (aged 7-17) by single photon emission tomography (SPET) using iodine-123-labelled 2␤-carbomethoxy-3␤(iodophenyl) tropane [ 123 I]␤-CIT as a tracer for monoamine transporters. In addition to the ordinary clinical examination, the patients were given a structured interview and information was gathered from teachers and parents with questionnaires. The diagnoses were established by consensus evaluation between three child psychiatrists. To test the serotonin hypothesis and the dopamine hypothesis regarding depression in children and adolescents, the series was divided into groups with depression present (31) and no depression present (10). In this study, the depressive child and adolescent patients had significantly higher serotonin transporter availability (P Ͻ 0.02) in the hypothalamic/midbrain area. Age did not correlate to the hypothalamic/midbrain serotonin transporter binding ratio. No significant difference in dopamine transporter availability in striatum was found between the depressive and the nondepressive children and adolescents. Molecular Psychiatry (2000) 5, 514-522.

Serotonin transporter binding with [123I]β-CIT SPECT in major depressive disorder versus controls: effect of season and gender

“…having relatives with psychiatric diagnoses) or patients (from different source populations) is the most probable explanation for the inconsistent findings. Previous studies recruited patients from general psychiatric outpatient and university clinics [7,8,10,12,18,19,30]. We recruited 65% of our patients from primary care settings.…”

Increased Brainstem Serotonergic Transporter Availability in Adult Migraineurs: an [18F]FP-CIT PET Imaging Pilot Study

“…One study investigated SERT availability in depressive drugnaïve children and adolescents using [ 123 I]β-CIT, but adults were not included in the study and no information is available in comparison to adults [19]. It cannot be excluded that SERT availability in the pediatric/adolescent population is different from that of adults, at least in migraine patients, considering different clinical characteristics of pediatric/adolescent migraine from adult migraine.…”

Brain Imaging in Mood Disorders

“…This effect, however, was reversed in the hypothalamus and midbrain, where increased SERT binding correlated with concurrent depression in a group of drug-naive children (n = 41). Increased binding could be attributed to a reduction of serotonin within the synaptic cleft (thus allowing increased tracer binding), with developmental differences accounting for contradictory results for transporter binding in adults and children (Dahlstrom et al, 2000).…”

“…This effect, however, was not reported in 31 drug-naive children. Serotonin transporter (SERT) binding (see below) but not DAT binding in the hypothalamus and midbrain was increased (Dahlstrom et al, 2000). Interestingly, during acute cocaine abstinence (n = 28), associated with depressive symptoms and a 20% increase in striatal DAT binding capacity measured by SPECT, there was a negative correlation of tracer binding with Hamilton depression scores (Malison et al, 1998a), suggesting an adaptive response.…”