Serotonin transporter binding and anxiety symptoms in Parkinson's disease
Serotonin transporter binding and anxiety symptoms in Parkinson's disease
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DOI：
10.1136/jnnp-2017-316193
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发表时间：
2018-01-01
影响因子：
11
通讯作者：
Vriend, Chris
中科院分区：
文献类型：
--
作者：
Joling, Merijn;van den Heuvel, Odile A.;Vriend, Chris
焦虑是帕金森病（PD）常见的神经精神症状，但其神经机制研究甚少。多巴胺能和血清素能信号的紊乱可能在其病理生理中起作用。i -123- n -omega-氟丙基-2 - β -碳甲氧基-3 β -（4-碘苯基）- nortropane （I-123-FP-CIT）是一种单光子发射CT放射性示踪剂，其结合在纹状体和纹状体外皮层下脑区分别主要结合突触前多巴胺转运体（DAT）和血清素转运体（SERT）。因此，DAT和SERT的可用性可能为多巴胺和血清素神经元的完整性提供一种体内测量方法。方法：我们研究了焦虑症状（用Beck焦虑量表的情感亚量表测量）与纹状体I-123-FP-CIT结合（额外）在127例疾病持续时间中位数为2.55年（IQR 2.90）年的PD非痴呆患者中的关联。我们对目前接受或未接受多巴胺替代疗法（DRT）的患者进行了分析。结果焦虑症状严重程度与右丘脑I-123-FP-CIT结合率呈显著负相关（β =-0.203, p=0.019; δ R-2=0.040）（多重检验p(corr) < 0.020）。在未接受DRT治疗的患者亚组（n=81）中，我们发现焦虑与丘脑123I-FP-CIT结合率之间存在显著的负相关（右：β =-0.349, p=0.001, δ R-2=0.119；左：β =-0.269, p=0.017, δ R-2=0.071） （p(corr) < 0.020）。结论PD患者焦虑水平升高与丘脑I-123-FP-CIT结合水平降低有关，提示PD患者焦虑症状与血清素能变性有关。
Background Anxiety is a common neuropsychiatric symptom in Parkinson's disease (PD), yet the neural mechanisms have been scarcely investigated. Disturbances in dopaminergic and serotonergic signalling may play a role in its pathophysiology. I-123-N-omega-fluoropropyl-2 beta-carbomethoxy-3 beta-(4-iodophenyl) nortropane (I-123-FP-CIT) is a single-photon emission CT radiotracer, and its binding in striatal and extrastriatal subcortical brain areas represents predominant binding to the presynaptic dopamine transporter (DAT) and the serotonin transporter (SERT), respectively. Availability of DAT and SERT may thus provide an in vivo measure for the integrity of both dopamine and serotonin neurons.Methods We studied the association between anxiety symptoms, measured with an affective subscale of the Beck Anxiety Inventory, and (extra) striatal I-123-FP-CIT binding in 127 non-demented patients with PD with a median disease duration of 2.55 (IQR 2.90) years. We conducted the analyses on patients currently on or not on dopamine replacement therapy (DRT).Results Severity of anxiety symptoms showed a significant negative association with I-123-FP-CIT binding ratios in the right thalamus (beta=-0.203, p=0.019;Delta R-2=0.040) (multiple testing p(corr) < 0.020). In the subgroup of patients not on DRT (n=81), we found a significant negative association between anxiety and thalamic 123I-FP-CIT binding ratios bilaterally (right: beta=-0.349, p=0.001,Delta R-2=0.119; left: beta=-0.269, p=0.017,Delta R-2=0.071) (p(corr) < 0.020).Conclusion This study shows that higher levels of anxiety in patients with PD are associated with lower thalamic I-123-FP-CIT binding, pointing towards a contribution of serotonergic degeneration to anxiety symptoms in PD.