Why is parkinsonism not a feature of human methamphetamine users?
Why is parkinsonism not a feature of human methamphetamine users?
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DOI：
10.1093/brain/awh046
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发表时间：
2004-02-01
期刊：
影响因子：
14.5
通讯作者：
Kish, SJ
中科院分区：
文献类型：
--
作者：
Moszczynska, A;Fitzmaurice, P;Kish, SJ
50多年来，甲基苯丙胺一直是一种广泛使用的兴奋剂药物，用于保持清醒和表现，高剂量时会引起强烈的欣快感。动物研究表明，甲基苯丙胺会导致大脑中神经递质多巴胺水平的短期甚至持续性消耗。然而，帕金森病（一种大脑多巴胺缺乏症）的临床特征似乎并不是人类甲基苯丙胺使用者的特征。我们将慢性甲基苯丙胺使用者尸检脑组织中的多巴胺水平与帕金森病患者和对照组的脑组织进行了比较。甲基苯丙胺使用者的尾状核（-61%）平均多巴胺水平比壳核（-50%）降低更多，这一模式与帕金森病相反。一些甲基苯丙胺使用者尾状核中的多巴胺水平严重降低，处于帕金森病范围内（多巴胺损失高达 97%），但壳核中的多巴胺水平却没有。由于壳核和尾状核分别促进运动和认知功能，我们的数据表明甲基苯丙胺使用者不是帕金森病患者，因为纹状体运动部分的多巴胺水平没有充分降低。然而，尾状核几乎完全减少可以解释一些吸毒者认知障碍的报告，有时甚至导致残疾，并表明在戒毒期间使用多巴胺替代药物（例如左旋多巴）治疗可能会有所帮助。
For more than 50 years, methamphetamine has been a widely used stimulant drug taken to maintain wakefulness and performance and, in high doses, to cause intense euphoria. Animal studies show that methamphetamine can cause short-term and even persistent depletion of brain levels of the neurotransmitter dopamine. However, the clinical features of Parkinson's disease, a dopamine deficiency disorder of the brain, do not appear to be characteristic of human methamphetamine users. We compared dopamine levels in autopsied brain tissue of chronic methamphetamine users with those in patients with Parkinson's disease and in a control group. Mean dopamine levels in the methamphetamine users were reduced more in the caudate (-61%) than in the putamen (-50%), a pattern opposite to that of Parkinson's disease. Some methamphetamine users had severely decreased dopamine levels, within the parkinsonian range, in the caudate (up to 97% dopamine loss) but not in the putamen. As the putamen and caudate subserve aspects of motor and cognitive function, respectively, our data suggest that methamphetamine users are not parkinsonian because dopamine levels are not sufficiently decreased in the motor component of the striatum. However, the near-total reduction in the caudate could explain reports of cognitive disturbances, sometimes disabling, in some drug users, and suggests that treatment with dopamine substitution medication (e.g. levodopa) during drug rehabilitation might be helpful.