The serotonergic system in Parkinson's patients with dyskinesia: evidence from imaging studies.
The serotonergic system in Parkinson's patients with dyskinesia: evidence from imaging studies.
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DOI：
10.1007/s00702-017-1823-7
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发表时间：
2018-08
期刊：
影响因子：
--
通讯作者：
Politis M
中科院分区：
文献类型：
--
作者：
Pagano G;Niccolini F;Politis M
本文综述了左旋多巴诱导（lid）和移植物诱导运动障碍（GIDs）帕金森病患者血清素能系统正电子发射断层扫描（PET）分子成像的现状。PET成像研究表明帕金森病的特征是多巴胺能和血清素能神经元的进行性丧失。经历过lid和GIDs的帕金森患者有5 -羟色胺能末端的异常扩散，导致壳核内5 -羟色胺能/多巴胺能末端比例增加。血清素能末端以非生理性方式将外源性左旋多巴转化为多巴胺，并在没有自动调节反馈的情况下释放异常量的多巴胺。这导致突触多巴胺水平的更高波动，从而导致lid和gid的发展。5-HT1A和5-HT1B受体激动剂对5-羟色胺能末端的调节部分减少了这些运动并发症。体内PET研究证实，壳核内5 -羟色胺能末端的异常扩散在lid和gid的发展中起着关键作用。然而，谷氨酸能、腺苷能、阿片系统和磷酸二酯酶10A也可能在这些运动并发症的发生中发挥作用。需要一种结合PET和MRI成像技术的综合多模态成像方法来充分了解lid和gid发展的机制。
The purpose of review is to review the current status of positron emission tomography (PET) molecular imaging of serotonergic system in Parkinson’s patients who experience levodopa-induced (LIDs) and graft-induced dyskinesias (GIDs). PET imaging studies have shown that Parkinson’s disease is characterized by progressive loss of dopaminergic and serotonergic neurons. Parkinson’s patients who experienced LIDs and GIDs have an aberrant spreading of serotonergic terminals, which lead to an increased serotonergic/dopaminergic terminals ratio within the putamen. Serotonergic terminals convert exogenous levodopa into dopamine in a non-physiological manner and release an abnormal amount of dopamine without an auto-regulatory feedback. This results in higher swings in synaptic levels of dopamine, which leads to the development of LIDs and GIDs. The modulation of serotonergic terminals with 5-HT1A and 5-HT1B receptors agonists partially reduced these motor complications. In vivo PET studies confirmed that abnormal spreading of serotonergic terminals within the putamen has a pivotal role in the development of LIDs and GIDs. However, glutamatergic, adenosinergic, opioid systems, and phosphodiesterases 10A may also play a role in the development of these motor complications. An integrative multimodal imaging approach combining PET and MRI imaging techniques is needed to fully understand the mechanisms underlying the development of LIDs and GIDs.
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