BRIEF RESEARCH REPORT article
Front. Hum. Neurosci.
Sec. Motor Neuroscience
Volume 19 - 2025 | doi: 10.3389/fnhum.2025.1621054
Therapeutic Effects of Striatal Dopaminergic Modulation on Idiopathic Dystonia and OCD in Humans: Insights from the Striosome Hypothesis.
Provisionally accepted
- 1Osaka Neurological Institute, Toyonaka, Ōsaka, Japan
- 2Mukogawa Women's University, Nishinomiya, Hyōgo, Japan
- 3Ritsumeikan University, Kyoto, Japan
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Emerging evidence suggests that striatal striosomes play a key role in the dopaminergic regulation of motor and mental action selection processes, with impairments leading to repetitive stereotyped movements (dystonias), thoughts (obsessions), and behaviors (compulsions). To explore this hypothesis therapeutically, we investigated how idiopathic dystonia and obsessive-compulsive disorder (OCD) respond to a novel dopaminergic treatment using low-dose L-DOPA combined with chlorpromazine (CPZ), which can primarily enhance striosomal D1 dopamine receptor (D1R) signaling in humans.The therapeutic effects of L-DOPA/CPZ were assessed over one year in 26 idiopathic dystonia patients (mean age, 55.9 years; 23.1% male) with OCD. The daily doses of L-DOPA/carbidopa and CPZ-phenolphthalinate were increased stepwise to 50 mg and 5 mg, respectively, three times daily over an 8-week period, and then maintained for a year. The severity of dystonia and OCD was evaluated using the Burke-Fahn-Marsden Dystonia Movement Scale (BFMDMS) and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).At a one-year follow-up, the BFMDMS and Y-BOCS scores improved by approximately 80% (mean difference, -13.8; 95% CI, -16.9 to -10.6; P < 0.0001) and 75% (mean difference, -16.0; 95% CI, -16.1 to -15.8; P < 0.0001), respectively, with no specific adverse effects. Thus, low-dose L-DOPA/CPZ provided striking and lasting benefits to patients with idiopathic dystonia and OCD.Our findings indicate that dystonia and OCD may share a common striatal dysfunction due to altered D1R signaling in the striosomes. Pharmacologic interventions aimed at modulating striosomal D1R signaling could enhance our understanding of the striatal mechanisms involved in the pathophysiology of both dystonia and OCD.
Keywords: Dystonia, Obsessive-Compulsive Disorder, striosome, Dopamine D1 receptors, D2 antagonist, dopaminergic treatment
Received: 30 Apr 2025; Accepted: 28 Jul 2025.
Copyright: © 2025 Matsumoto, Shimazu and Goto. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Satoshi Goto, Ritsumeikan University, Kyoto, Japan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.