Imbalance of biogenic amines in patients with compulsive disorders and tics

Introduction: In children tics and compulsive disorders are often associated. The clinical symptoms vary between solitary tics and predominant compulsive symptoms. In these patients an imbalance of central neurotransmitter biogenic amines have been reported.

Patients and Methods: We report the CSF (cerebro spinal fluid) biogenic amines results of 6 patients, 4 with solitary tics and 2 with compulsive symptoms of different degree. The analysis was performed using high pressure liquid chromatography (HPLC).

Results: In 4 of 6 patients we found pathological decreased biogenic amines in CSF: Boy R. M., 8 years old; solitary tics: decreased 5-hydroxyindolaceticacid (5HIAA) 76 nmol/l, decreased homovanillic acid (HVA) 83 nmol/l. Girl C. C., 8 years old, tics and compulsive symptoms: decreased 5HIAA 70 nmol/l, normal HVA 250 nmol/l. Girl M. M, 6 years old: solitary tic: decreased 5HIAA 61 nmol/l, normal HVA 280 nmol/l. (Reference values 2–8 years: HVA 140–700 nmol/l, 5HIAA 80–200 nmol/l). Boy D. H., 13 years old: tics and massive compulsions (Gilles-de-la-Tourette syndrome): decreased 5HIAA 30 nmol/l (70–150 nmol) and decreased HVA 113 nmol/l (140–500 nmol). Two patients with tic disorders showed normal values for biogenic amines in CSF.

Conclusion: Searching for compulsive symptoms in children with tic disorders is mandatory. The reported findings support the hypothesis that there is an imbalance of central neurotransmitter systems in tic- and compulsive disorders. In tic disorders the sensomotoric-dopaminergic modulated system seems to be affected, in compulsive disorders the serotonergic modulated system. Maybe the measurement of biogenic amines in CSF can support therapeutic decisions concerning neurotransmitter modulating drugs.

Keywords: neurotransmitter, biogenic amines, tic, compulsive disorder, therapy