Mov Disord: 帕金森患者的精神相关症状,血清素和多巴胺生成系统是"罪魁祸首"?

2021-09-21 Freeeman MedSci原创

这些发现强调了血清素能变性在帕金森病不同病程后出现的几种神经精神症状的表达中的突出作用。

帕金森病(PD)的特点是多种单胺能系统的进行性退化,导致广泛的临床表现。越来越多的证据表明,血清素能和多巴胺能系统在这些运动和非运动障碍中都有影响。

然而,尽管有两项以遗传形式进行的横断面研究,但对这两种单胺变性的同时研究以及它们各自在整个PD过程中参与临床表现的情况仍不甚了解。事实上,以前的工作基本上证明了纹状体多巴胺能病变的进展及其与运动严重程度和疾病持续时间的相关性,但也证明了疾病发生时存在补偿机制。

目前,分析探索5-羟色胺能神经支配的地形和演变的研究很少。

最近使用PET-[11C]DASB的工作表明,PD与特定的协作模式有关,DASB在纹状体和黑质的结合减少,而在下丘脑和海马体的结合保留,与疾病持续时间相关。

一项纵向研究使用[123I]FP-CIT-SPECT评估早期患者的剑突状5-羟色胺转运体密度,结果显示,在2年的随访中,震颤为主和姿势不稳/步态紊乱表型的结合率逐渐降低。

藉此, 法国2Université Claude Bernard Lyon的Audrey Maillet 等人,通过使用突触前多巴胺能([11C]PE2I)和5-羟色胺能([11C]DASB)示踪剂结合临床和PET神经影像学方法,提供一个更清晰的双重退化过程的图像。

为此,他们将把两组病程短、表现出或不表现出冷漠的PD患者与病程中长的患者进行比较。此外,根据独立于病程的神经精神表现的严重程度进行分层,进而有助于确定这些症状的病理生理学。

他们进行了一项横断面研究,结合临床和双示踪剂正电子发射断层扫描(PET)的神经成像方法,使用多巴胺放射配体 ([11 C]DASB)的再摄取,在不同病程的帕金森病患者中(即短病程的无药可治(n = 27,0-2年病程),患有淡漠症(n = 14)或没有(n = 13);中病程(n = 15,4-7年病程)和长病程,无痴呆(n = 15,8-10年病程)患者)。同时还招募了15名年龄匹配的健康受试者。

他们发现:
(1) 多巴胺能和5-羟色胺能的病变随着帕金森病的持续时间而恶化,从中脑/皮层下向皮层区域扩散;
(2) 帕金森病发病时存在冷漠与更严重的皮层和皮层下5-羟色胺能和多巴胺能的破坏有关,类似于在中等病程患者中观察到的神经支配模式。
(3) 帕金森病的冷漠、抑郁和特质焦虑的严重程度似乎主要与皮质边缘区的血清素能改变有关。

总的来说,这些发现强调了血清素能变性在帕金森病不同病程后出现的几种神经精神症状的表达中的突出作用。

 

原文出处:
Maillet A, Météreau E, Tremblay L, et al. Serotonergic and Dopaminergic Lesions Underlying Parkinsonian Neuropsychiatric Signs. Mov Disord. Published online September 8, 2021:mds.28722. doi:10.1002/mds.28722

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1220397, encodeId=66e6122039e65, content=<a href='/topic/show?id=e00a4322000' target=_blank style='color:#2F92EE;'>#多巴胺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43220, encryptionId=e00a4322000, topicName=多巴胺)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=赛华佗, createdTime=Tue May 17 16:38:38 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2013708, encodeId=387d2013e082f, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sat Apr 30 09:21:28 CST 2022, time=2022-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784460, encodeId=caf41e844602d, content=<a href='/topic/show?id=a727600194' target=_blank style='color:#2F92EE;'>#Disord#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6001, encryptionId=a727600194, topicName=Disord)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aad0444, createdName=cmsvly, createdTime=Tue Sep 28 18:21:28 CST 2021, time=2021-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053777, encodeId=275c1053e7780, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/OYUBdYwpzERRhaq8Io8n1oyxY425KCwzsxAVz3NhWfIegfJEhOiaswPtFIPwIanc8PNrEzNSQdDFlMQ6m1TMjmQ/132, createdBy=a5552515416, createdName=xuehj, createdTime=Wed Sep 22 13:43:54 CST 2021, time=2021-09-22, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1220397, encodeId=66e6122039e65, content=<a href='/topic/show?id=e00a4322000' target=_blank style='color:#2F92EE;'>#多巴胺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43220, encryptionId=e00a4322000, topicName=多巴胺)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=赛华佗, createdTime=Tue May 17 16:38:38 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2013708, encodeId=387d2013e082f, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sat Apr 30 09:21:28 CST 2022, time=2022-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784460, encodeId=caf41e844602d, content=<a href='/topic/show?id=a727600194' target=_blank style='color:#2F92EE;'>#Disord#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6001, encryptionId=a727600194, topicName=Disord)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aad0444, createdName=cmsvly, createdTime=Tue Sep 28 18:21:28 CST 2021, time=2021-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053777, encodeId=275c1053e7780, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/OYUBdYwpzERRhaq8Io8n1oyxY425KCwzsxAVz3NhWfIegfJEhOiaswPtFIPwIanc8PNrEzNSQdDFlMQ6m1TMjmQ/132, createdBy=a5552515416, createdName=xuehj, createdTime=Wed Sep 22 13:43:54 CST 2021, time=2021-09-22, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1220397, encodeId=66e6122039e65, content=<a href='/topic/show?id=e00a4322000' target=_blank style='color:#2F92EE;'>#多巴胺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43220, encryptionId=e00a4322000, topicName=多巴胺)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=赛华佗, createdTime=Tue May 17 16:38:38 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2013708, encodeId=387d2013e082f, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sat Apr 30 09:21:28 CST 2022, time=2022-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784460, encodeId=caf41e844602d, content=<a href='/topic/show?id=a727600194' target=_blank style='color:#2F92EE;'>#Disord#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6001, encryptionId=a727600194, topicName=Disord)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aad0444, createdName=cmsvly, createdTime=Tue Sep 28 18:21:28 CST 2021, time=2021-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053777, encodeId=275c1053e7780, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/OYUBdYwpzERRhaq8Io8n1oyxY425KCwzsxAVz3NhWfIegfJEhOiaswPtFIPwIanc8PNrEzNSQdDFlMQ6m1TMjmQ/132, createdBy=a5552515416, createdName=xuehj, createdTime=Wed Sep 22 13:43:54 CST 2021, time=2021-09-22, status=1, ipAttribution=)]
    2021-09-28 cmsvly
  4. [GetPortalCommentsPageByObjectIdResponse(id=1220397, encodeId=66e6122039e65, content=<a href='/topic/show?id=e00a4322000' target=_blank style='color:#2F92EE;'>#多巴胺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43220, encryptionId=e00a4322000, topicName=多巴胺)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=赛华佗, createdTime=Tue May 17 16:38:38 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2013708, encodeId=387d2013e082f, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sat Apr 30 09:21:28 CST 2022, time=2022-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784460, encodeId=caf41e844602d, content=<a href='/topic/show?id=a727600194' target=_blank style='color:#2F92EE;'>#Disord#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6001, encryptionId=a727600194, topicName=Disord)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aad0444, createdName=cmsvly, createdTime=Tue Sep 28 18:21:28 CST 2021, time=2021-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053777, encodeId=275c1053e7780, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/OYUBdYwpzERRhaq8Io8n1oyxY425KCwzsxAVz3NhWfIegfJEhOiaswPtFIPwIanc8PNrEzNSQdDFlMQ6m1TMjmQ/132, createdBy=a5552515416, createdName=xuehj, createdTime=Wed Sep 22 13:43:54 CST 2021, time=2021-09-22, status=1, ipAttribution=)]
    2021-09-22 xuehj

    不错

    0

相关资讯

JAMA Neurol:全麻状态丘脑下核深部脑刺激对帕金森患者临床症状的影响

与局部麻醉状态下相比,帕金森患者全麻状态下,丘脑下核深部脑刺激对患者认知、情绪和行为不良反应改善无显著影响,但患者手术负担减轻,手术时间缩短。

JAMA:肌酐——尿酸升高疗法用于延缓早期帕金森病患者病情进展

在早期帕金森病患者中,与安慰剂相比,肌苷治疗在延缓临床疾病进展方面无显著作用,研究结果不支持肌苷用于早期PD的治疗

Mov Disord:惊喜!女性绝经年龄越晚,帕金森病风险越低

女性绝经年龄越晚,帕金森病风险越低

Neurology : 帕金森患者,使用吡马西林,长期住院和死亡风险如何?

和不使用吡马西林者相比,老年人使用吡马西林与开始使用后一个月的住院风险增加。同时,使用后一年的死亡风险也增加。

JAMA Neurology:帕金森,深度脑刺激,全麻和局麻哪个好?

睡眠与清醒的DBS的主要结果没有差异

Mov Disord : 皮下注射左旋多巴新药,治疗帕金森,效果如何

ND0612的皮下注射左旋多巴/卡比多巴连续输液总体上是安全的

拓展阅读

European Radiology:弥散基础频谱成像检测早期帕金森病黑质和白质束的病理改变

为了解决弥散张量成像的局限性,研究发展了弥散基谱成像 (DBSI)以粗量化各向异性扩散张量反映轴突的完整性,其在多种中枢神经系统疾病中的敏感性和准确性已被证实。

帕金森病睡眠量表修订版(PDSS-2)

帕金森病睡眠量表修订版(PDSS-2)

神经科一周速递:热点解读进展大盘点!

一周热点分享 ,紧跟神经科学前沿,让每一次诊疗都更精准,点击立即查看!

早发性帕金森病临床变异性|疑难探究

发病年龄小于50岁的帕金森病被称为早发型帕金森病,发病年龄在21~50为青年型帕金森病,21岁以前发病的被称为少年型帕金森病。

帕金森病:想睡个好觉太难!

帕金森病(PD)患者昼夜节律的改变不仅会影响睡眠-觉醒周期调节,同样会对非运动症状造成影响。

论文解读|Huifang Shang教授团队最新研究揭示与帕金森病相关的PLXNA1基因的罕见变异

研究揭示了与神经系统疾病和帕金森综合症有关的PLXNA1基因罕见变异。

2024 NICE 诊断指南:帕金森病远程监测设备 [DG51]

英国国家卫生与临床优化研究所(NICE,National Institute for Health and Clinical Excellence) · 2024-01-25

2023 NICE 技术鉴定指南:左旋多巴/卡比多巴组合治疗伴有运动症状的晚期帕金森病[TA934]

英国国家卫生与临床优化研究所(NICE,National Institute for Health and Clinical Excellence) · 2023-11-29

帕金森病患者睡眠障碍评估与护理干预的最佳证据总结

浙江中医药大学护理学院 · 2023-08-10

早中期帕金森病患者运动管理的最佳证据总结

山东第一医科大学附属省立医院老年神经内科 · 2023-05-10