title: Hypothalamic digoxin deficiency in obsessive compulsive disorder and la Tourette's syndrome.
abstract: The isoprenoid pathway related cascade was assessed in 15 patients with obsessive compulsive disorder (OCD) and la Tourette's syndrome (TS). The pathway was also assessed in right hemispheric dominant, left hemispheric dominant, and bihemispheric dominant individuals to assess whether hemispheric dominance has any correlation with these disease states. The levels of serum digoxin, HMG CoA reductase activity, and dolichol were found to be decreased in OCD and la Tourette's syndrome as well as in left hemispheric dominant individuals with a corresponding increase in RBC Na(+)-K+ ATPase activity, serum ubiquinone, and magnesium levels. There was an increase in tyrosine and its catabolites, and a reduction in tryptophan and its catabolites in the serum. The total and individual glycosaminoglycan (GAG) fractions, carbohydrate residues of glycoproteins, and the concentration of glycolipids decreased in the serum. The activity of GAG degrading enzymes and glycohydrolases were decreased. The RBC membrane glycoconjugates were increased while the membrane cholesterol:phospholipid ratio was decreased. The activity of free radical scavenging enzymes increased while the concentration of free radicals decreased significantly. On the other hand, there was hyperdigoxinemia and the reverse biochemical patterns in those with right hemispheric dominance. Membrane Na(+)-K+ ATPase stimulation can result in decreased intracellular Ca2+ and increased magnesium levels. Increased levels of dopamine can lead to a tic syndrome, while reduced levels of serotonin and increased dopamine can both lead to obsessive compulsive disorder. Decrease in fucose and sialo-ligands, increased immunosuppressive morphine levels, decreased T-cell calcineurin signal transduction related to decreased intracellular calcium, reduced free radical production, and altered presentation of bacterial glycoconjugate antigens can lead to a hypoimmune response and recurrent respiratory infection in OCD patients. OCD and la Tourette's syndrome are associated with left hemispheric chemical dominance.
authors.affiliation: Department of Neurology, Medical College Hospital, Trivandrum, Kerala, India.
authors.forename: Ravi Kumar
authors.initials: RK
authors.lastname: Kurup
authors.forename: Parameswara Achutha
authors.initials: PA
authors.lastname: Kurup
mesh_terms: D002784:Cholesterol / Q000097:blood; D004077:Digoxin / Q000097:blood*; D004286:Dolichols / Q000097:blood; D004292:Dominance, Cerebral / Q000502:physiology; D004910:Erythrocyte Membrane / Q000201:enzymology / Q000378:metabolism; D007839:Functional Laterality; D006025:Glycosaminoglycans / Q000378:metabolism; D006801:Humans; D006903:Hydroxymethylglutaryl CoA Reductases / Q000097:blood; D007031:Hypothalamus / Q000378:metabolism* / Q000503:physiopathology; D009771:Obsessive-Compulsive Disorder / Q000097:blood / Q000201:enzymology / Q000378:metabolism*; D011106:Polyisoprenyl Phosphates / Q000097:blood / Q000378:metabolism; D015398:Signal Transduction / Q000502:physiology; D000254:Sodium-Potassium-Exchanging ATPase / Q000378:metabolism; D005879:Tourette Syndrome / Q000097:blood / Q000201:enzymology / Q000378:metabolism*; D014364:Tryptophan / Q000378:metabolism; D014443:Tyrosine / Q000378:metabolism
chemical_list: D004286:Dolichols; D006025:Glycosaminoglycans; D011106:Polyisoprenyl Phosphates; D014443:Tyrosine; D004077:Digoxin; D014364:Tryptophan; D002784:Cholesterol; D006903:Hydroxymethylglutaryl CoA Reductases; D000254:Sodium-Potassium-Exchanging ATPase