Garwood Elisabeth R, Bekele Wosen, McCulloch Charles E, Christine Chadwick W
Pennsylvania State University School of Medicine, USA.
Neurotoxicology. 2006 Dec;27(6):1003-6. doi: 10.1016/j.neuro.2006.03.015. Epub 2006 Mar 28.
Since the 1930's, amphetamine drugs have been used therapeutically and recreationally. High doses are associated with acute injury to axon terminals of dopaminergic neurons. It is unknown whether low dose exposure to amphetamine over a prolonged time period is associated with the development of Parkinson's disease (PD).
A telephone survey of drug and chemical exposure was administered to patients from three faculty practice clinics at UCSF. Patients were asked to participate if they had been diagnosed with peripheral neuropathy (PN), amyotrophic lateral sclerosis (ALS), or PD between the ages of 40 and 64. Spouses or caregivers were also asked to participate. "Amphetamine exposure" was defined as a prior use of amphetamine, methamphetamine or dextroamphetamine. "Prolonged exposure" was defined as amphetamine use that occurred more than twice a week for > or =3 months or weekly usage for > or =1 year and had to occur before diagnosis of the neurological condition.
Prolonged exposure to either prescribed or non-prescribed amphetamine was common, occurring in 15% with PN (11/76), 13% with ALS (9/72), and 11% with PD (17/158). Prolonged amphetamine exposure was more frequent in diseased patients compared to spouses when all diseases were combined (adjusted OR=3.15, 95% CI 1.42-7.00, p=0.005). When tested alone, only the Parkinson's disease group retained statistical significance (adjusted OR=8.04, 95% CI 1.56-41.4, p=0.013). For most individuals, exposure occurred long before diagnosis (averages: PN 25 years, ALS 28 years, and PD 27 years).
The elevated rate of prolonged amphetamine exposure in PD is intriguing and bears further investigation.
自20世纪30年代以来，苯丙胺类药物一直被用于治疗和消遣。高剂量使用与多巴胺能神经元轴突终末的急性损伤有关。长期低剂量接触苯丙胺是否与帕金森病（PD）的发生有关尚不清楚。
对来自加州大学旧金山分校三个教职员工诊所的患者进行了药物和化学物质接触情况的电话调查。如果患者在40至64岁之间被诊断患有周围神经病变（PN）、肌萎缩侧索硬化症（ALS）或PD，则被邀请参与调查。配偶或护理人员也被邀请参与。“苯丙胺接触”定义为既往使用过苯丙胺、甲基苯丙胺或右旋苯丙胺。“长期接触”定义为每周使用苯丙胺超过两次，持续≥3个月，或每周使用≥1年，且必须在神经疾病诊断之前发生。
长期接触处方或非处方苯丙胺的情况很常见，PN患者中有15%（11/76）、ALS患者中有13%（9/72）、PD患者中有11%（17/158）出现这种情况。将所有疾病合并后，患病患者长期接触苯丙胺的情况比配偶更频繁（校正比值比=3.15，95%可信区间1.42 - 7.00，p = 0.005）。单独测试时，只有帕金森病组具有统计学意义（校正比值比=8.04，95%可信区间1.56 - 41.4，p = 0.013）。对于大多数个体，接触发生在诊断前很久（平均：PN为25年，ALS为28年，PD为27年）。
PD患者中长时间苯丙胺接触率升高这一现象很有趣，值得进一步研究。
