Post-hoc analysis with correction for psychiatric co-morbidity showed a significant difference in binding in the hippocampus between DRD patients and controls ( p = 0.00). Sleep disturbances were correlated with binding in the dorsal raphe nucleus (all participants: r s = 0.45, p = 0.04 patients: r s = 0.64, p = 0.05) and participants with a psychiatric disorder had a lower binding in the hippocampus (all participants: p = 0.00 patients: p = 0.06). Univariate- and network-analysis did not show differences in binding between DRD patients compared to controls. Ten DRD, 14 cervical dystonia patients and 12 controls were included. Dynamic DASB PET scans, a marker of serotonin transporter availability, were performed. Our study aimed to investigate the serotonergic system in vivo in the brain of`DRD patients and correlate this to (non-)motor symptoms. The high prevalence of non-motor symptoms suggests involvement of the serotonergic pathway. GTP-cyclohydrolase deficiency in dopa-responsive dystonia (DRD) patients impairs the biosynthesis of dopamine, but also of serotonin.
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