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帕金森病中多巴胺能对高级认知的调节作用:PET揭示的前额叶皮质的作用

Dopaminergic modulation of high-level cognition in Parkinson's disease: the role of the prefrontal cortex revealed by PET.

作者信息

Cools Roshan, Stefanova Elka, Barker Roger A, Robbins Trevor W, Owen Adrian M

机构信息

Department of Experimental Psychology, University of Cambridge, Cambridge, UK.

出版信息

Brain. 2002 Mar;125(Pt 3):584-94. doi: 10.1093/brain/awf052.

Abstract

This study examined the effects of L-dopa medication in patients with Parkinson's disease on cortical and subcortical blood flow changes during two tasks known to involve frontostriatal circuitry. Eleven patients with Parkinson's disease were scanned on two occasions, one ON L-dopa medication and one OFF L-dopa medication, during performance of the Tower of London planning task and a related test that emphasized aspects of spatial working memory. L-dopa-induced decreases were observed in the right dorsolateral prefrontal cortex during performance of both the planning and the spatial working memory tasks compared with the visuomotor control task. Conversely, L-dopa-induced blood flow increases were observed in the right occipital lobe during the memory task relative to the control task. Data from age-matched healthy volunteers demonstrated that L-dopa effectively normalized blood flow in these regions in the patient group. Moreover, a significant correlation was found between L-dopa-induced, planning related blood flow decreases in the right dorsolateral prefrontal cortex and L-dopa-induced changes in performance on the planning task. These data suggest that L-dopa ameliorates high-level cognitive deficits in Parkinson's disease by inducing relative blood flow changes in the right dorsolateral prefrontal cortex.

摘要

本研究考察了帕金森病患者服用左旋多巴药物后,在两项已知涉及额纹状体回路的任务中,皮质和皮质下血流变化情况。11名帕金森病患者在执行伦敦塔计划任务以及一项强调空间工作记忆方面的相关测试时,分别在服用左旋多巴药物和未服用左旋多巴药物的两种情况下接受扫描。与视觉运动控制任务相比,在执行计划任务和空间工作记忆任务时,服用左旋多巴后右侧背外侧前额叶皮质血流减少。相反,与控制任务相比,在记忆任务期间,服用左旋多巴后右侧枕叶血流增加。来自年龄匹配的健康志愿者的数据表明,左旋多巴可有效使患者组这些区域的血流恢复正常。此外,右侧背外侧前额叶皮质中左旋多巴诱导的、与计划相关的血流减少与左旋多巴诱导的计划任务表现变化之间存在显著相关性。这些数据表明,左旋多巴通过诱导右侧背外侧前额叶皮质相对血流变化,改善帕金森病患者的高级认知缺陷。

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